61. Aikenhead 2011: Effectiveness and cost-effectiveness of paediatric bariatric surgery: a systematic review

LLM response

24 quote(s) from publication full text (mean similarity 98.7%)

A1
Quote: "We performed a systematic review to examine the effectiveness of surgical interventions to treat obese children and adolescents, and whether they are cost-effective."
Reasoning: The research question and inclusion criteria were established before conducting the review.
[Yes]

A2
Quotes: "Searches were conducted in PubMed, Embase, ISI Web of Science and the Cochrane Library to 6 September 2010, and hand-searched bibliographies. We included articles with English abstracts if they examined subjects aged ≤19 years of age, reported at least one postoperative weight loss measure and at least 1 year of postoperative follow-up."
Reasoning: At least two databases were searched and bibliographies were hand-searched.
[Yes]

A3
Quotes: "Searches were conducted in PubMed, Embase, ISI Web of Science and the Cochrane Library to 6 September 2010, and hand-searched bibliographies. We included articles with English abstracts if they examined subjects aged ≤19 years of age, reported at least one postoperative weight loss measure and at least 1 year of postoperative follow-up."
Reasoning: Multiple databases were searched and bibliographies were hand-searched. Inclusion criteria are stated.
[Yes]

A4
Quote: "We included articles with English abstracts if they examined subjects aged ≤19 years of age, reported at least one postoperative weight loss measure and at least 1 year of postoperative follow-up."
Reasoning: Only articles with English abstracts were included, suggesting publication status was used as an inclusion criterion.
[Yes]

A5
Quote: "Refer to flow diagram in Appendix 2."
Reasoning: A flow diagram of included and excluded studies is provided in Appendix 2.
[Yes]

A6
Quotes: "Thirty-seven relevant papers on bariatric surgery effectiveness in 831 children or adolescents were included, spanning 36 years. Thirteen studies examined gastric banding, with mean body mass index (BMI) reductions ranging from 8.5 to 43 kg m−2."
"All but two papers (35,43) described baseline comorbid conditions, which included amenorrhea, depression, dyslipidaemia, hypertension, insulin resistance, metabolic syndrome, orthopaedic problems, osteoarthritis, sleep apnoea and type 2 diabetes."
Reasoning: Aggregate data on participant characteristics, interventions and outcomes are provided.
[Yes]

A7
Quotes: "We included articles with English abstracts if they examined subjects aged ≤19 years of age, reported at least one postoperative weight loss measure and at least 1 year of postoperative follow-up."
"Existing evidence – although based generally on underpowered, retrospective studies – suggests that bariatric surgery in older children results in significant weight loss and improvements in comorbidities and quality of life."
Reasoning: Inclusion criteria are stated and the quality of included studies is discussed narratively, but no formal quality assessment is reported.
[No]

A8
[NA] - No formal quality assessment was conducted, so this item is not applicable.

A9
[NA] - No meta-analysis was conducted, so assessing the appropriateness of methods for combining studies is not applicable.

A10
[NA] - No meta-analysis was conducted, so assessing publication bias is not applicable.

A11
Quote: "The project that led to this paper was funded by the WHO Health Evidence Network of the World Health Organization. The funder had no role in the design, analysis or interpretation of the study. The views expressed are those of the authors and do not necessarily reflect the position of the funding body."
Reasoning: Sources of support for the systematic review are acknowledged, but sources of support for the included studies are not reported.
[No]

P1
Quote: "Effectiveness and cost-effectiveness of paediatric bariatric surgery: a systematic review"
Reasoning: The title identifies the article as a systematic review.
[Yes]

P2
Quote: See the structured abstract on page 1 of the full text PDF.
Reasoning: A structured abstract with labeled sections is provided.
[Yes]

P3
Quote: "Despite reports of levelling off in some countries (1–3), childhood obesity and its associated morbidities and costs are considerable and increasing in scale in many countries (4,5), particularly among socioeconomically disadvantaged segments of many populations (6). Obese children and adolescents are more likely than their normal weight peers to suffer endocrine, cardiovascular, pulmonary, orthopaedic, psychosocial and other complications associated with excessive weight, many of which persist into adulthood (7–9)."
Reasoning: The rationale for the review is described in the context of the increasing prevalence and health consequences of childhood obesity.
[Yes]

P4
Quote: "We performed a systematic review to examine the effectiveness of surgical interventions to treat obese children and adolescents, and whether they are cost-effective."
Reasoning: The research questions are explicitly stated, referencing the population (obese children and adolescents), intervention (surgical interventions), and outcomes of interest (effectiveness and cost-effectiveness).
[Yes]

P5
[No] - No mention of a review protocol or registration number.

P6
Quotes: "We included articles with English abstracts if they examined subjects aged ≤19 years of age, reported at least one postoperative weight loss measure and at least 1 year of postoperative follow-up."
"At least one postoperative weight loss measure had to be reported, with a minimum follow-up time of 1 year post surgery."
Reasoning: Eligibility criteria for study characteristics (population, intervention, outcomes, follow-up duration) and report characteristics (English abstracts) are specified.
[Yes]

P7
Quote: "Searches were conducted in PubMed, Embase, ISI Web of Science and the Cochrane Library to 6 September 2010, and hand-searched bibliographies."
Reasoning: Information sources (databases with search end date and bibliography searching) are described.
[Yes]

P8
Quotes: "Appendix 1 contains details of the search terms."
"1a. PubMed search terms
#1. obes*[TIAB] OR overweight*[TIAB] OR weight loss[TIAB] OR weight reduc*[TIAB] OR BMI[TIAB] = 172 843
#2. child[TIAB] OR children[TIAB] OR adolescen*[TIAB] OR pediatr*[TIAB] OR paediatr*[TIAB] = 909 583
#3. bariatric[TIAB] OR gastric surgery[TIAB] OR gastroplasty[TIAB] OR gastrectomy[TIAB] OR gastric bypass[TIAB] OR jejunoileal bypass[TIAB] OR gastrointestinal diversion[TIAB] OR gastrointestinal surgery[TIAB] OR biliopancreatic diversion[TIAB] OR biliopancreatic bypass[TIAB] OR gastric band*[TIAB] OR gastrectomy[TIAB] OR LAGB[TIAB] OR stomach stapl*[TIAB] OR lap band*[TIAB] OR lapband*[TIAB] OR roux-en-y[TIAB] OR malabsorptive surgery[TIAB] OR restrictive surgery[TIAB] OR restrictive procedure[TIAB] OR duodenal switch[TIAB] OR antiobesity surgery[TIAB] OR weight loss surgery[TIAB] OR weight reduction surgery[TIAB] OR surgery[TIAB] OR surgical[TIAB] = 973 334
#4. #1 AND #2 AND #3 = 950"
Reasoning: The full electronic search strategy is provided for PubMed.
[Yes]

P9
Quote: "Refer to flow diagram in Appendix 2."
Reasoning: The study selection process is illustrated in a flow diagram.
[Yes]

P10
[No] - The method of data extraction is not described.

P11
[No] - Variables for which data were sought are not explicitly defined.

P12
[No] - Methods for assessing risk of bias in individual studies are not described.

P13
[NA] - No meta-analysis was conducted, so summary measures are not applicable.

P14
[NA] - No meta-analysis was conducted.

P15
[NA] - No meta-analysis was conducted, so assessing risk of bias across studies is not applicable.

P16
[NA] - No additional analyses were reported.

P17
Quote: "Refer to flow diagram in Appendix 2."
Reasoning: A flow diagram illustrating the number of studies screened, assessed for eligibility, included and excluded with reasons is provided.
[Yes]

P18
Quote: "Appendix 3, Table A1"
Reasoning: Study characteristics including country, study type, sample size, follow-up duration, baseline BMI, postop BMI, and whether comorbidities were measured are provided for each included study in Table A1.
[Yes]

P19
[No] - Risk of bias assessments for individual studies are not presented.

P20
[No] - Results for individual studies are not fully reported. Effect estimates and confidence intervals are lacking.

P21
[NA] - No meta-analysis was conducted.

P22
[NA] - No meta-analysis was conducted, so reporting results of risk of bias assessment across studies is not applicable.

P23
[NA] - No additional analyses were reported.

P24
Quote: "Thirty-seven relevant papers on bariatric surgery effectiveness in 831 children or adolescents were included, spanning 36 years. This review serves to update an early systematic review on the topic by Treadwell et al. in 2008 (33), including case studies with less than three patients (n = 11) and 14 articles published after the December 2007 cut-off used by Treadwell et al."
Reasoning: The main findings are summarized, including the number of studies, total participants, and key results in relation to a previous review.
[Yes]

P25
Quotes: "Existing evidence – although based generally on underpowered, retrospective studies – suggests that bariatric surgery in older children results in significant weight loss and improvements in comorbidities and quality of life."
"Results were not broadly comparable given a lack of consistency across surgeons, procedures and reported outcomes."
"Accurate information for low frequency outcomes like mortality and complications was sparse."
"No studies on clinical effectiveness reported on costs, and only one study addressed bariatric surgery cost in children."
Reasoning: Limitations at the study level (underpowered retrospective studies), outcome level (lack of comparability) and review level (sparse data on rare outcomes, lack of cost data) are discussed.
[Yes]

P26
Quote: "Bariatric surgery is promoted as a treatment option for children and adolescents for several reasons as outlined above, but these also generate some controversy. Proponents in the surgical community suggest that the procedure is justified by weight loss results from clinical trials in adults, and should form part of a multidisciplinary paediatric weight management strategy to address life-threatening comorbidities seen in morbidly obese children. They add that delaying treatment and allowing comorbid conditions to progress could be equally or more disadvantageous, and that in practice, most adult bariatric centres already perform adolescent surgery (73). It is argued that, in principle, treatment risks are accepted when the benefits of treatment outweigh the risks of withholding treatment, and that the use of bariatric surgery in paediatric weight management should be seen as an extension of age-related, i.e. when the risks of chronic comorbidities should outweigh the risks of surgery for patients at any age."
Reasoning: The results are interpreted in the context of the rationale for bariatric surgery in youth and the risks and benefits at different ages. Implications for practice are discussed.
[Yes]

P27
Quote: "The project that led to this paper was funded by the WHO Health Evidence Network of the World Health Organization. The funder had no role in the design, analysis or interpretation of the study. The views expressed are those of the authors and do not necessarily reflect the position of the funding body."
Reasoning: Sources of funding for the systematic review are described and the role of the funder is made explicit.
[Yes]

62. Al-Hozaim 2010: Laparoscopic-assisted anorectal pull-through for anorectal malformations: a systematic review and the need for standardization of outcome reporting

LLM response

23 quote(s) from publication full text (mean similarity 98.9%)

A1. Was an 'a priori' design provided?
Quotes: None relevant.
Reasoning: No mention of a protocol, ethics approval, or a priori objectives.
[No]

A2. Was there duplicate study selection and data extraction?
Quotes: "A data extraction form was created to standardize the collection of study elements from each included article. This form included the following information: inclusion/exclusion criteria, study title, author, characteristics of the journal (year of publication), study design, study period, sample size, and the focus of the study in use of the LAARP as a primary procedure or after colostomy."
Reasoning: Data extraction was standardized but no mention of it being done in duplicate.
[No]

A3. Was a comprehensive literature search performed?
Quotes: "A systematic search of the MEDLINE, PUBMED, and Cochrane databases (June 2000 to April 2008) was conducted. The search terms used were "laparoscopic," "pull-through," "anorectal malformation," and "imperforate anus." In addition, a manual search of 4 surgical journals from the same period was performed. The journals searched were "The Journal of Pediatric Surgery," "Pediatric Surgery International," "Surgical Endoscopy," and "Journal of Laparoendoscopic & Advanced Surgical Techniques.""
Reasoning: At least 2 databases plus manual search of journals were used.
[Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
Quotes: None relevant.
Reasoning: No mention of including grey literature or unpublished studies.
[No]

A5. Was a list of studies (included and excluded) provided?
Quotes: None relevant.
Reasoning: No list of included or excluded studies provided.
[No]

A6. Were the characteristics of the included studies provided?
Quotes: "The studies included 124 patients—96 males (77.4%) and 28 females (22.6%). Of the 124 patients, 110 (88.7%) had undergone previous colostomy, whereas 14 patients (11.2%) had undergone a primary laparoscopic repair without a colostomy. Most patients (80%) had either a high or intermediate ARM."
Reasoning: Aggregate characteristics of patients from included studies were provided.
[Yes]

A7. Was the scientific quality of the included studies assessed and documented?
Quotes: "Analysis of study designs revealed 2 prospective studies (11.7%) [2,3], 4 comparative studies (23.5%) [2,4–6], and no randomized studies."
Reasoning: Study designs were assessed but no formal quality assessment was performed.
[No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
Quotes: "One in 5000 infants is born with an ARM. The evolution of surgical techniques for dealing with this complex group of malformations led to the description of the PSARP by deVries and Pena [18] in 1982. Posterior sagittal anorectoplasty quickly became the standard of care for dealing with ARM. Despite the excellent exposure of anatomy and exact placement of the distal rectum within the muscle complex, the technique is not perfect, especially in patients with "high" ARM defects [19–21]."
Reasoning: The limitations of the included studies were not considered when formulating conclusions.
[No]

A9. Were the methods used to combine the findings of studies appropriate?
Quotes: None relevant.
Reasoning: This was a systematic review without a meta-analysis, so no combining of study findings was performed.
[NA]

A10. Was the likelihood of publication bias assessed?
Quotes: None relevant.
Reasoning: No assessment of publication bias was mentioned.
[NA]

A11. Was the conflict of interest included?
Quotes: None relevant.
Reasoning: No disclosure of funding sources or conflicts of interest for the systematic review or included studies.
[No]

P1. Title: Identify the report as a systematic review, meta-analysis, or both.
Quote: "Laparoscopic-assisted anorectal pull-through for anorectal malformations: a systematic review and the need for standardization of outcome reporting"
Reasoning: The title identifies the article as a systematic review.
[Yes]

P2. Abstract / Structured summary
Quote: The abstract contains labeled sections for Introduction, Methods, Results, and Conclusion.
Reasoning: The abstract is structured with distinct sections.
[Yes]

P3. Introduction / Rationale
Quote: "Over the past several years, techniques have evolved in the repair of high and intermediate anorectal malformations (ARMs), starting with the abdominoperineal pull-through, sacroperineal pull-through, and posterior sagittal anorectoplasty (PSARP) and now moving toward the recently reported laparoscopically assisted anorectal pull-through (LAARP) procedure."
Reasoning: Provides rationale for the review in the context of the evolution of ARM repair techniques.
[Yes]

P4. Introduction / Objectives
Quote: "The aim of this review was to conduct a systematic review to evaluate the worldwide experience with LAARP with regard to indications, outcomes, and quality of reporting in published articles."
Reasoning: Explicitly states the objectives of the review.
[Yes]

P5. Methods / Protocol and registration
Quotes: None relevant.
Reasoning: No mention of a review protocol or registration number.
[No]

P6. Methods / Eligibility criteria
Quote: "Inclusion criteria were studies of ARMs, regardless of level of the defect, with or without associated anomalies, use of LAARP as a primary procedure or with colostomy, and studies reported after the year 2000. Exclusion criteria included studies that were not reported in English and those that did not deal with human subjects."
Reasoning: Eligibility criteria for included studies are specified.
[Yes]

P7. Methods / Information sources
Quote: "A systematic search of the MEDLINE, PUBMED, and Cochrane databases (June 2000 to April 2008) was conducted" [...] "In addition, a manual search of 4 surgical journals from the same period was performed."
Reasoning: Databases searched and date ranges are provided.
[Yes]

P8. Methods / Search
Quote: "The search terms used were "laparoscopic," "pull-through," "anorectal malformation," and "imperforate anus.""
Reasoning: Search terms are provided but full search strategy is not reported.
[No]

P9. Methods / Study selection
Quote: "Only studies published in full were included."
Reasoning: Minimal details on the study selection process are provided.
[No]

P10. Methods / Data collection process
Quote: "A data extraction form was created to standardize the collection of study elements from each included article."
Reasoning: A standardized data extraction form was used but no mention of the process being piloted or done in duplicate.
[No]

P11. Methods / Data items
Quote: "This form included the following information: inclusion/exclusion criteria, study title, author, characteristics of the journal (year of publication), study design, study period, sample size, and the focus of the study in use of the LAARP as a primary procedure or after colostomy."
Reasoning: The data items collected are listed.
[Yes]

P12. Methods / Risk of bias in individual studies
Quotes: None relevant.
Reasoning: No assessment of risk of bias in individual studies was mentioned.
[No]

P13. Methods / Summary measures
Quotes: None relevant.
Reasoning: No principal summary measures were specified.
[No]

P14. Methods / Synthesis of results
Quotes: None relevant.
Reasoning: No meta-analysis was performed in this review.
[NA]

P15. Methods / Risk of bias across studies
Quotes: None relevant.
Reasoning: No assessment of risk of bias across studies was mentioned.
[NA]

P16. Methods / Additional analyses
Quotes: None relevant.
Reasoning: No additional analyses were mentioned.
[NA]

P17. Results / Study selection
Quote: "Seventeen studies were included in the final analysis. Of the included studies, none were randomized, 2 were prospective in nature, and 4 compared outcomes of posterior sagittal anorectoplasty and LAARP. The studies included 124 patients (96 males, 28 females) with 80% reported as having high/intermediate malformations."
Reasoning: The number of included studies and reasons for exclusions are provided, but no flow diagram is included.
[No]

P18. Results / Study characteristics
Quote: "The studies included 124 patients—96 males (77.4%) and 28 females (22.6%). Of the 124 patients, 110 (88.7%) had undergone previous colostomy, whereas 14 patients (11.2%) had undergone a primary laparoscopic repair without a colostomy. Most patients (80%) had either a high or intermediate ARM."
Reasoning: Aggregate characteristics of the included studies are provided but not for each individual study.
[No]

P19. Results / Risk of bias within studies
Quotes: None relevant.
Reasoning: No assessment of risk of bias within individual studies was reported.
[No]

P20. Results / Results of individual studies
Quotes: See Table 4 which summarizes key characteristics and outcomes from 4 comparative studies.
Reasoning: For a subset of studies, outcome data and follow-up periods are provided for each study group.
[Yes]

P21. Results / Synthesis of results
Quotes: None relevant.
Reasoning: No meta-analysis was performed.
[NA]

P22. Results / Risk of bias across studies
Quotes: None relevant.
Reasoning: No assessment of risk of bias across studies was reported.
[NA]

P23. Results / Additional analysis
Quotes: None relevant.
Reasoning: No additional analyses were reported.
[NA]

P24. Discussion / Summary of evidence
Quote: "One in 5000 infants is born with an ARM. The evolution of surgical techniques for dealing with this complex group of malformations led to the description of the PSARP by deVries and Pena [18] in 1982. Posterior sagittal anorectoplasty quickly became the standard of care for dealing with ARM. Despite the excellent exposure of anatomy and exact placement of the distal rectum within the muscle complex, the technique is not perfect, especially in patients with "high" ARM defects [19–21]."
Reasoning: Key findings are summarized but strength of evidence is not explicitly stated.
[No]

P25. Discussion / Limitations
Quote: "As a result, widespread adoption of the LAARP by the pediatric surgery community has taken place in recent years. Perceived advantages of LAARP include excellent visualization of the rectal fistula and accurate placement of the pull-through segment at the center of the levator sling without dividing the muscles that control continence, which is an inevitability of PSARP."
Reasoning: Advantages of LAARP are discussed but limitations of the review itself are not addressed.
[No]

P26. Discussion / Conclusions
Quote: "In conjunction with the increased interest in minimal access surgery in children, there has been increased awareness among surgeons of the importance of evidence-based surgery."
Reasoning: A general conclusion is provided in the context of the need for evidence-based surgery in pediatrics.
[Yes]

P27. Funding
Quotes: None relevant.
Reasoning: No sources of funding or support are reported.
[No]

63. Allen 2015: Pediatric emergency department thoracotomy: A large case series and systematic review

LLM response

15 quote(s) from publication full text (mean similarity 92.7%)

A1 - Protocol/a priori design:
Quote: "We reviewed our experience and performed a systematic review of reports of EDT in pediatric patients."
Reasoning: No mention of a protocol or a priori design.
[No]

A2 - Duplicate study selection and data extraction:
No relevant quotes found.
Reasoning: No mention of duplicate study selection or data extraction.
[No]

A3 - Comprehensive literature search:
Quote: "We reviewed our experience and performed a systematic review of all published reports of EDT in pediatric patients."
Reasoning: Only mentions reviewing published reports, no details on databases, keywords, or supplementary strategies.
[No]

A4 - Grey literature as inclusion criterion:
No relevant quotes found.
Reasoning: No mention of including grey literature.
[No]

A5 - List of included and excluded studies:
No relevant quotes found. 
Reasoning: No list of included or excluded studies provided.
[No]

A6 - Characteristics of included studies:
Quote: "These reports obtained from a Medline search and our publications regarding EDT in the pediatric population for the past 40 year using the keywords "thoracotomy", "emergency", "trauma", "resuscitation", "pediatrics", and "children"."
Reasoning: Some study characteristics are mentioned but not provided in an aggregated form like a table.
[No]

A7 - Quality assessment of included studies:
No relevant quotes found.
Reasoning: No mention of assessing quality or risk of bias of included studies.
[No]

A8 - Quality used appropriately in conclusions:
No relevant quotes found.
Reasoning: Quality not assessed (A7), so cannot be used in conclusions.
[NA]

A9 - Appropriate methods to combine studies:
Quote: "To minimize variability by each series, to minimize the effect of outliers, and to allow for generalizations to be made. Selection bias may have also affected results, as all EDT were performed at the discretion of the trauma physician."
Reasoning: Mentions variability between studies but no statistical test for heterogeneity. No meta-analysis performed.
[NA]

A10 - Publication bias assessed:
No relevant quotes found.
Reasoning: No assessment of publication bias. No meta-analysis performed.
[NA]

A11 - Conflicts of interest stated:
No relevant quotes found.
Reasoning: No mention of funding sources or conflicts of interest.
[No]

P1 - Title identifies as systematic review/meta-analysis:
Quote: "Pediatric emergency department thoracotomy: A large case series and systematic review"  
Reasoning: Title clearly identifies the article as a systematic review.
[Yes]

P2 - Structured abstract:
Quote: The abstract contains labeled sections for Background/purpose, Methods, Results, and Conclusion.
Reasoning: The abstract is structured with distinct labeled sections.
[Yes]

P3 - Rationale:
Quote: "Trauma remains the leading cause of morbidity and mortality in children and adolescents [1,2]. By recognizing this, care of the injured child has improved with aggressive efforts to standardize treatment."
Reasoning: Provides rationale for the review in the context of the importance of pediatric trauma care.
[Yes]

P4 - Objectives:
Quote: "To address this issue, we reviewed our experience at a level 1 trauma center and report the largest analysis over the past 25 years. In conjunction, we performed a systematic review of all published reports regarding pediatric EDT and combined the data from those reports with the data from our institution"
Reasoning: Clearly states the objectives of reviewing their experience and systematically reviewing the literature on pediatric EDT.
[Yes]

P5 - Protocol/registration:
No relevant quotes found.
Reasoning: No mention of a protocol or registration number.
[No]

P6 - Eligibility criteria:
Quote: "These reports obtained from a Medline search and our publications regarding EDT in the pediatric population for the past 40 year using the keywords "thoracotomy", "emergency", "trauma", "resuscitation", "pediatrics", and "children". Bibliographies of relevant publications were reviewed to identify reports that were not initially located with the Medline search."
Reasoning: Describes the inclusion criteria of pediatric EDT publications in the past 40 years identified through a Medline search and bibliography review.
[Yes]

P7 - Information sources:
Quote: "These reports obtained from a Medline search and our publications regarding EDT in the pediatric population for the past 40 year using the keywords "thoracotomy", "emergency", "trauma", "resuscitation", "pediatrics", and "children". Bibliographies of relevant publications were reviewed to identify reports that were not initially located with the Medline search."
Reasoning: States that Medline and bibliography searching were used, but no dates of coverage provided.
[Yes]

P8 - Search:
Quote: "These reports obtained from a Medline search and our publications regarding EDT in the pediatric population for the past 40 year using the keywords "thoracotomy", "emergency", "trauma", "resuscitation", "pediatrics", and "children"."
Reasoning: Keywords are provided but not the full search strategy for replication.
[No]

P9 - Study selection:
Quote: "These reports obtained from a Medline search and our publications regarding EDT in the pediatric population for the past 40 year using the keywords "thoracotomy", "emergency", "trauma", "resuscitation", "pediatrics", and "children". Bibliographies of relevant publications were reviewed to identify reports that were not initially located with the Medline search."
Reasoning: Describes the process for identifying relevant studies through Medline searching and bibliography review.
[Yes]

P10 - Data collection process:
Quote: "For publications that did not report certain variables, those cases were systematically excluded when analyzing that missing variable."
Reasoning: Mentions that cases with missing data were excluded from certain analyses, but no details on how data was extracted.
[No]

P11 - Data items:
Quote: "For publications that did not report certain variables, those cases were systematically excluded when analyzing that missing variable. Although each series differs in the specific data reported, the information obtained was pooled and analyzed using the variables and outcomes reported by each series."
Reasoning: Variables analyzed were those reported in each series, but a list of all variables is not provided.
[No]  

P12 - Risk of bias in individual studies:
No relevant quotes found.
Reasoning: No mention of assessing risk of bias in individual studies.
[No]

P13 - Summary measures:
Quote: "MOIs included gunshot wound (GSW) (74%), stab wound (15%), and motor vehicle collision (8%). In the field, 46% had initial VS and 67% had SOL. Upon arrival, 25% had VS and 56% had SOL."
Reasoning: Proportions are presented as the main summary measures.
[Yes]

P14 - Synthesis of results:
No relevant quotes found.
Reasoning: No meta-analysis was performed.
[NA]

P15 - Risk of bias across studies:
No relevant quotes found.
Reasoning: No mention of assessing risk of bias across studies.
[NA]

P16 - Additional analyses:
No relevant quotes found.
Reasoning: No mention of any additional analyses.
[NA]

P17 - Study selection results:
No relevant quotes found.
Reasoning: Numbers of studies screened, excluded, and included are not provided, and no flow diagram is present.
[No]

P18 - Study characteristics:
Quote: Table 1 provides a systematic review of the published case series regarding pediatric EDT along with data from Ryder Trauma Center.
Reasoning: Study characteristics are provided in an aggregated table format with citations.
[Yes]

P19 - Risk of bias within studies:
No relevant quotes found.
Reasoning: Risk of bias assessments for individual studies are not reported.
[No]

P20 - Results of individual studies:
Quote: Fig. 1 shows outcomes according to MOI, presence of VS/SOL, and experience of Ryder Trauma Center for each included study.
Reasoning: Forest plots are not provided, but results for individual studies are presented graphically in Fig. 1 and Fig. 2.
[Yes]

P21 - Synthesis of results:
No relevant quotes found.
Reasoning: No meta-analysis was performed.
[NA]

P22 - Risk of bias across studies:
No relevant quotes found.
Reasoning: No assessment of risk of bias across studies was reported.
[NA]

P23 - Additional analyses:
No relevant quotes found.
Reasoning: No additional analyses were reported.
[NA]

P24 - Summary of evidence:
Quote: "Overall, the mortality rates are comparable between adults and pediatric patients following EDT. Children who sustain blunt force trauma and are without SOL at the scene or at their community hospital emergency department. During this development, the resuscitative thoracotomy was also added as an extension to ATLS techniques [19]. Now after 30 years, we are able to systematically review the current literature with this relatively aggressive resuscitative measure in the pediatric population."
Reasoning: Summarizes the main findings on mortality rates and factors associated with outcomes in pediatric EDT.
[Yes]

P25 - Limitations:
Quote: "There are limitations to this study. First, all of the data obtained from our institution were collected retrospectively, and thus not specifically collected for research purposes. As for all data reviewed, some of the variables may have been missing or misclassified. Also, differences in trauma management between physicians and institutions may not allow for generalizations to be made. Selection bias may have also affected results, as all EDT were performed at the discretion of the trauma physician."
Reasoning: Discusses several limitations of the study, including retrospective data collection, missing data, differences in management between centers, and selection bias.
[Yes]

P26 - Conclusions:
Quote: "There is growing interest in the use of a resuscitative endovascular balloon occlusion of the aorta (REBOA) to control hemorrhagic shock in trauma patients. To our knowledge, the REBOA remains a new and still controversial tool. There are limited reports regarding its use in trauma patients. Recently, Brenner et al. tested the technical feasibility of REBOA in adult patients in hemorrhagic shock [25]. Although they concluded it is feasible to use, their technique is during the initial phase of aneurysm. Some believe its main use in trauma could be for placement by emergency medical personnel to temporize a patient prior to transfer to definitive care."
Reasoning: The conclusions discuss the growing interest in and limitations of REBOA as an alternative resuscitative measure to EDT in trauma patients.
[Yes]

P27 - Funding:
No relevant quotes found.
Reasoning: Sources of funding and support are not reported.
[No]

64. Allin 2015: Challenges of Improving the Evidence Base in Smaller Surgical Specialties, as Highlighted by a Systematic Review of Gastroschisis Management

LLM response

26 quote(s) from publication full text (mean similarity 99.8%)

A1
Quotes: "The review was conducted according to a pre-specified protocol. The protocol was registered on the Prospero International Prospective Register of Systematic Reviews (CRD42012003241)."
Reasoning: The authors state that the review was conducted according to a pre-specified protocol that was registered, indicating an a priori design.
[Yes]

A2
Quotes: "Identified titles were assessed for inclusion by two investigators (BA and WT) acting independently. Any conflicts were resolved by a third investigator (MK). Data from included articles were extracted independently by the same two investigators (BA and WT), and any differences resolved by discussion."
Reasoning: Study selection and data extraction were done independently by two investigators with a process for resolving disagreements.
[Yes]

A3
Quotes: "All study designs except expert opinion were included, and no restrictions were made on the basis of study language or geographical location."
Reasoning: The authors searched multiple databases and did not restrict by language or location, but do not provide full details on the search strategy or supplementary sources.
[No]

A4
Quotes: "All study designs except expert opinion were included, and no restrictions were made on the basis of study language or geographical location."
Reasoning: The authors explicitly state that all study designs except expert opinion were included regardless of publication status.
[Yes]

A5
Quotes: "Using the stated search strategy, 3081 papers were identified. After removal of duplicates, 751 unique articles remained. From this, 8 papers were deemed to meet the inclusion criteria, all of which were cohort studies (Fig. 1). No randomised controlled trials were identified that met the inclusion criteria."
Reasoning: The authors provide the numbers of included and excluded studies with reasons for exclusions at each stage in a flow diagram.
[Yes]

A6
Quotes: "Although reporting of baseline characteristics was variably done by the included studies, where it was reported, there were no statistically significant differences in birth-weight, gestational age, or associated anomalies between the OPFC and SR groups."
Reasoning: Some baseline characteristics of included studies are provided, but in an incomplete and aggregated way.
[No]

A7
Quotes: "Methodological quality and risk of bias were assessed using the STROBE checklist and GRADE criteria."
Reasoning: The authors state the tools used to assess study quality and risk of bias.
[Yes]

A8
Quotes: "Our results would appear to suggest a potential benefit to OPFC over SR. A recently published meta-analysis by Kunz et al [13] agrees with these findings when infants with only simple gastroschisis are included. However, when infants with complex gastroschisis are included in their analysis, they arrive at the conclusion that SR is superior to OPFC. This variation in conclusion highlights one of the key limitations of performing meta-analysis in small specialties. With a lack of standardised populations, interventions or outcome measures, and a scarcity of high quality primary data, inclusion criteria for systematic reviews often have to be more lax than is ideal. This leads to the introduction of significant clinical heterogeneity between the included studies, which may lead to a lack of validity for the conclusions of any meta-analysis."
Reasoning: The authors discuss the quality of included studies when interpreting the results and formulating the conclusions of the review.
[Yes]

A9
Quotes: "Data were synthesized using standard methods as described in the Cochrane Reviewers Handbook [8]. The chi-squared test for heterogeneity was used to assess the extent to which the results of the studies were in agreement. Using a conservative cut-off of p<0.01, no statistical heterogeneity was detected and therefore fixed-effect methods were used throughout. Dichotomous outcomes were meta-analysed using Mantel–Haenszel fixed effects methods to produce summary odds ratios with 95% confidence intervals. Continuous variables were meta-analysed using the inverse-variance fixed-effect method to produce weighted mean differences and 95% confidence intervals."
Reasoning: Appropriate methods were used to assess heterogeneity and synthesize the results.
[Yes]

A10
Quotes: "Although we have attempted to address this potential lack of validity with strict inclusion and exclusion criteria, our conclusion that OPFC is superior to SR must still be tempered by the low quality of the available primary data, and the limitations of our study."
Reasoning: The authors acknowledge the potential impact of publication bias on their conclusions, but do not formally assess it.
[No]

A11
Quotes: "Marian Knight is funded by a National Institute for Health Research Professorship. This article presents independent research partly funded by the National Institute for Health Research (NIHR)."
Reasoning: Sources of support for the systematic review are reported, but sources of support for the included studies are not.
[No]

P1
Quote: "Challenges of Improving the Evidence Base in Smaller Surgical Specialties, as Highlighted by a Systematic Review of Gastroschisis Management"
Reasoning: The title identifies the article as a systematic review.
[Yes]

P2
Quote: See structured abstract with labeled sections including background, methods, results, and conclusions.
Reasoning: The article provides a structured abstract with the specified sections.
[Yes]

P3
Quote: "Gastroschisis is an increasingly common paediatric surgical condition [1], with an incidence in the United Kingdom of approximately 3.5/10000 births [2]. Multiple surgical repair strategies have been developed, which vary based upon whether general anesthesia is used to perform the repair, and whether closure is operative or non-operative [3–6]."
Reasoning: The introduction describes the rationale for the review in the context of what is already known about gastroschisis management strategies.
[Yes]

P4
Quote: "The aim of this study, therefore, was to perform a systematic review of the literature comparing outcomes of infants with simple gastroschisis following either OPFC or SR. From this study we aimed to identify some of the reasons why research in paediatric surgery is currently largely unable to provide a strong evidence base to inform clinical practice."
Reasoning: The introduction states the aim of the systematic review, referencing the population (infants with simple gastroschisis), interventions (OPFC and SR), and outcomes of interest.
[Yes]

P5
Quote: "The review was conducted according to a pre-specified protocol. The protocol was registered on the Prospero International Prospective Register of Systematic Reviews (CRD42012003241)."
Reasoning: The methods state that a review protocol exists and provide its registration number.
[Yes]

P6
Quote: "Studies were included if they involved infants born with simple gastroschisis, defined as gastroschisis with an intact continuous bowel that is not compromised or breached at delivery or presentation. Infants with complex gastroschisis, defined as the presence of at least one of intestinal perforation, necrosis, or atresia were excluded from this review, as they only account for approximately 11.5% of infants with gastroschisis, are known to have a worse prognosis than the majority with simple gastroschisis [2], and thus represent a major confounder in any examination of the outcomes of different management techniques."
Reasoning: The methods specify the study characteristics (participants, interventions) used as eligibility criteria and rationale.
[Yes]

P7
Quote: "All study designs except expert opinion were included, and no restrictions were made on the basis of study language or geographical location."
Reasoning: The information sources are not fully described, lacking specific databases, dates, and the date last searched.
[No]

P8
Quotes: None relevant
Reasoning: The full search strategy is not presented for any database.
[No]

P9
Quote: "Identified titles were assessed for inclusion by two investigators (BA and WT) acting independently. Any conflicts were resolved by a third investigator (MK)."
Reasoning: The process for selecting studies is described.
[Yes]

P10
Quote: "Data from included articles were extracted independently by the same two investigators (BA and WT), and any differences resolved by discussion. Where required, unpublished data were requested from the authors of each of the included studies to allow for meta-analysis."
Reasoning: The method of data extraction is described, including obtaining unpublished data from investigators.
[Yes]

P11
Quotes: None relevant
Reasoning: The data items sought are not explicitly defined.
[No]

P12
Quote: "Methodological quality and risk of bias were assessed using the STROBE checklist and GRADE criteria."
Reasoning: The methods for assessing risk of bias of individual studies are described.
[Yes]

P13
Quotes: "Dichotomous outcomes were meta-analysed using Mantel–Haenszel fixed effects methods to produce summary odds ratios with 95% confidence intervals. Continuous variables were meta-analysed using the inverse-variance fixed-effect method to produce weighted mean differences and 95% confidence intervals."
Reasoning: The principal summary measures (odds ratios, mean differences) are stated.
[Yes]

P14
Quote: "Data were synthesized using standard methods as described in the Cochrane Reviewers Handbook [8]. The chi-squared test for heterogeneity was used to assess the extent to which the results of the studies were in agreement. Using a conservative cut-off of p<0.01, no statistical heterogeneity was detected and therefore fixed-effect methods were used throughout."
Reasoning: The methods for synthesizing results and assessing consistency are described.
[Yes]

P15
Quotes: None relevant
Reasoning: Methods for assessing risk of bias that may affect the cumulative evidence are not specified.
[No]

P16
Quotes: None relevant
Reasoning: No additional analyses are mentioned.
[NA]

P17
Quote: See Figure 1 study flow diagram.
Reasoning: A study flow diagram is provided with numbers of studies screened, assessed for eligibility, included, and excluded with reasons.
[Yes]

P18
Quote: "The included studies comprised a total of 804 infants with simple gastroschisis, 488 of whom underwent OPFC and 316 of whom underwent SR. The largest study was Owen 2010 [2] with 290 eligible patients. The majority of the remaining studies included fewer than 50 participants (Table 2)."
Reasoning: Some study characteristics are presented for each included study, but incompletely.
[No]

P19
Quote: "Methodological quality and risk of bias were assessed using the STROBE checklist and GRADE criteria."
Reasoning: Risk of bias assessments are mentioned but the results are not presented for each study.
[No]

P20
Quotes: None relevant
Reasoning: Simple summary data and effect estimates for each study are not provided for any outcomes.
[No]

P21
Quotes: See Figure 2 forest plots and Table 3 summary outcome measures.
Reasoning: Meta-analysis results including odds ratios, mean differences, and confidence intervals are presented for each outcome.
[Yes]

P22
Quotes: None relevant
Reasoning: No assessments of risk of bias across studies are reported.
[NA]

P23
Quotes: None relevant
Reasoning: No additional analyses are reported.
[NA]

P24
Quote: "Our results would appear to suggest a potential benefit to OPFC over SR. A recently published meta-analysis by Kunz et al [13] agrees with these findings when infants with only simple gastroschisis are included. However, when infants with complex gastroschisis are included in their analysis, they arrive at the conclusion that SR is superior to OPFC. This variation in conclusion highlights one of the key limitations of performing meta-analysis in small specialties. With a lack of standardised populations, interventions or outcome measures, and a scarcity of high quality primary data, inclusion criteria for systematic reviews often have to be more lax than is ideal. This leads to the introduction of significant clinical heterogeneity between the included studies, which may lead to a lack of validity for the conclusions of any meta-analysis."
Reasoning: The main findings are summarized along with their strength and relevance to key groups.
[Yes]

P25
Quote: "Although we have attempted to address this potential lack of validity with strict inclusion and exclusion criteria, our conclusion that OPFC is superior to SR must still be tempered by the low quality of the available primary data, and the limitations of our study."
Reasoning: Limitations at the study, outcome, and review level are discussed.
[Yes]

P26
Quote: "A National Paediatric Surgical Trials Unit could act both as a centre to facilitate co-operation between individual surgical centres, and as a research unit in its own right. By encouraging co-operation between individual centres, study power would be improved, heterogeneity between study populations would be reduced and outcome measures would become more standardised. With buy-in and co-operation from each of the individual surgical centres, a National Paediatric Surgical Trials Unit would have the ability to develop an overarching research programme that would allow generation of sufficient quality data to not only evaluate existing practice, but to take new surgical ideas through from initial evaluation to assessment with national randomised controlled trials, and on to large scale review of established practice, as outlined by the IDEAL recommendations [15]. A similar national approach could be used in other smaller surgical specialties."
Reasoning: The authors provide a general interpretation of the results in the context of other evidence and implications for future research.
[Yes]

P27
Quote: "Marian Knight is funded by a National Institute for Health Research Professorship. This article presents independent research partly funded by the National Institute for Health Research (NIHR)."
Reasoning: Sources of funding for the systematic review are described.
[Yes]

65. Alzahem 2011: Laparoscopic versus open inguinal herniotomy in infants and children: a meta-analysis

LLM response

22 quote(s) from publication full text (mean similarity 99.3%)

A1. Was an 'a priori' design provided?
Quotes: None relevant
Reasoning: The text does not mention a protocol, ethics approval, or pre-determined research objectives.
[No]

A2. Was there duplicate study selection and data extraction? 
Quotes: "Data extraction: Retrieved articles were assessed for eligibility and data on patients, intervention, control, outcomes and methodological quality were abstracted independently by two authors. Discrepancies were resolved by discussion and consensus."
Reasoning: Study selection and data extraction were done independently by two authors.
[Yes]

A3. Was a comprehensive literature search performed?
Quotes: "The search strategy is summarized in Fig. 1. All potential publications from Medline (1950–June 2010), Embase (1980–June 2010), The Cochrane Library (issue 2, 2010) and ongoing trials through http://www.clinicaltrials.gov website were identified."
Reasoning: At least 2 electronic databases plus a supplementary source were searched.
[Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
Quotes: None relevant
Reasoning: The text does not state that they searched for reports regardless of publication type or whether they excluded studies based on publication status.
[No]

A5. Was a list of studies (included and excluded) provided?
Quotes: None relevant 
Reasoning: The text does not provide or reference a list of included and excluded studies.
[No]

A6. Were the characteristics of the included studies provided?
Quotes: "Table 1 Comparative studies reporting laparoscopic inguinal hernia repair in infants and children"
Reasoning: Key characteristics of the included studies were provided in an aggregated table.
[Yes]

A7. Was the scientific quality of the included studies assessed and documented?
Quotes: "The quality of the included comparative studies was assessed independently by two authors. The Cochrane Collaboration criteria for randomized controlled trials was utilized (randomization, allocation concealment, blinding and completeness of follow-up). Cohort studies were assessed using the Newcastle-Ottawa Quality Assessment Scale [18]. The methodological details of the included studies were extracted from the published data."
Reasoning: The methodological quality of included studies was assessed using the Cochrane criteria for RCTs and the Newcastle-Ottawa scale for cohort studies.
[Yes]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
Quotes: "Although our review utilized a very comprehensive search strategy to minimize the effect of publication bias, only two randomized clinical trial was included. Therefore, our review is a summary of the existing evidence with limitation to the conclusions drawn from these data due to the quality of the included studies."
Reasoning: The conclusions acknowledge the limitations due to the quality of the included studies.
[Yes]

A9. Were the methods used to combine the findings of studies appropriate?
Quotes: "Heterogeneity was defined as a significant test of heterogeneity (p < 0.1) and/or differences in the treatment effects across studies."
Reasoning: Heterogeneity was assessed to determine appropriateness of combining studies, though a meta-analysis was not performed.
[NA]

A10. Was the likelihood of publication bias assessed?
Quotes: None relevant
Reasoning: Publication bias was not assessed, likely because there were fewer than 10 included studies.
[NA] 

A11. Was the conflict of interest included?
Quotes: None relevant
Reasoning: Sources of support for the systematic review and included studies were not acknowledged.
[No]

P1. Title
Quotes: "Laparoscopic versus open inguinal herniotomy in infants and children: a meta-analysis"
Reasoning: The title identifies the report as a meta-analysis.
[Yes]

P2. Abstract / Structured summary
Quotes: The abstract contains labeled sections for Purpose, Methods, Results, and Conclusions.
Reasoning: The abstract is structured with distinct labeled sections covering the key elements.
[Yes]

P3. Introduction / Rationale
Quotes: "Inguinal hernia repair is one of the most frequently performed pediatric surgical operations [1]. Open repair of an inguinal hernia has been accepted as the method of choice since it was first described more than 50 years ago due to its lower morbidity, good cosmesis, and lower rates of recurrence [2–4]."
Reasoning: The introduction describes the rationale for the review in the context of what is known about inguinal hernia repair in children.
[Yes]

P4. Introduction / Objectives
Quotes: "Purpose To undertake a meta-analysis of comparative data of laparoscopic versus open inguinal herniotomy in infants and children."
Reasoning: The purpose statement specifies the review question in terms of the population, interventions and comparator.
[Yes]

P5. Methods / Protocol and registration
Quotes: None relevant
Reasoning: The text does not mention a review protocol or registration.
[No]

P6. Methods / Eligibility criteria
Quotes: "Inclusion criteria: All comparative studies of the laparoscopic and open approaches for indirect inguinal hernia in children aged less than 19 years were selected. The primary outcome measure was the recurrence rate. Other clinically important outcomes such as rate of contralateral PPV, operative time, postoperative pain and recovery, cosmesis, postoperative testicular atrophy, postoperative hydrocele and stitch granuloma/abscess were also sought."
Reasoning: The eligibility criteria for included studies are specified.
[Yes]

P7. Methods / Information sources
Quotes: "The search strategy is summarized in Fig. 1. All potential publications from Medline (1950–June 2010), Embase (1980–June 2010), The Cochrane Library (issue 2, 2010) and ongoing trials through http://www.clinicaltrials.gov website were identified."
Reasoning: The information sources searched are described.
[Yes]

P8. Methods / Search
Quotes: "The following subject headings (MeSH) and text word terms were utilized: inguinal hernia, laparoscopy, minimal access surgery, infant(s), neonate(s), newborn(s), child, paediatric, pediatric. No language restriction was applied. Additional citations were sought using references in articles retrieved from searches."
Reasoning: The full search strategy is not presented, but the key search terms are provided.
[No]

P9. Methods / Study selection
Quotes: None relevant
Reasoning: The process for selecting studies is not explicitly described.
[No]

P10. Methods / Data collection process
Quotes: "Data extraction: Retrieved articles were assessed for eligibility and data on patients, intervention, control, outcomes and methodological quality were abstracted independently by two authors. Discrepancies were resolved by discussion and consensus."
Reasoning: The method of data extraction is described, involving two independent authors and a process for resolving discrepancies.
[Yes]

P11. Methods / Data items
Quotes: None relevant
Reasoning: The text does not explicitly define all variables for which data were sought.
[No]

P12. Methods / Risk of bias in individual studies
Quotes: "The quality of the included comparative studies was assessed independently by two authors. The Cochrane Collaboration criteria for randomized controlled trials was utilized (randomization, allocation concealment, blinding and completeness of follow-up). Cohort studies were assessed using the Newcastle-Ottawa Quality Assessment Scale [18]."
Reasoning: The methods used to assess risk of bias in individual studies are described.
[Yes]

P13. Methods / Summary measures
Quotes: "For dichotomous outcomes, odds ratio (OR) and its associated confidence interval were calculated. For continuous outcomes, treatment effect was expressed as mean difference and its calculated standard deviation."
Reasoning: The principal summary measures are stated.
[Yes]

P14. Methods / Synthesis of results
Quotes: None relevant
Reasoning: Methods for data synthesis are not described, as a meta-analysis was not performed.
[NA]

P15. Methods / Risk of bias across studies
Quotes: None relevant
Reasoning: Methods for assessing risk of bias across studies are not described, as a meta-analysis was not performed.
[NA]

P16. Methods / Additional analyses
Quotes: "A sensitivity analysis was conducted where studies limited to girls, and/or with a median follow-up less than 6 months, and/or addressing a complicated hernia, and/or limited to infants were excluded and the meta-analysis of the remaining 6 comparative studies had shown a comparable recurrence rate among the groups [OR = 0.87; 95% CI 0.34–2.23; p = 0.76] (Fig. 2b)."
Reasoning: A sensitivity analysis was conducted.
[Yes]

P17. Results / Study selection
Quotes: "Initial electronic search yielded 290 Medline, 216 Embase, 5 Cochrane Library (issue 2, 2010) and 7 ClinicalTrials.gov potentially relevant citations. After screening the abstracts, 48 articles were reviewed in full texts. Thirty-four articles have met the predefined inclusion criteria (Fig. 1). Ten published studies were identified (Niyogi [19]; Tsai [20]; Koivusalo [21]; Endo [22]; Bharathi [23]; Hassan [24]; Koivusalo [25]; Chan [17]; Oue [26]; Antao [27]) in which the laparoscopic and open approaches for repair of pediatric inguinal hernias were directly compared (Table 1) [17, 19–27]."
Reasoning: A flow diagram of the study selection process is not provided, but the numbers of studies screened, assessed for eligibility, and included are reported in the text.
[No]

P18. Results / Study characteristics
Quotes: "Table 1 Comparative studies reporting laparoscopic inguinal hernia repair in infants and children"
Reasoning: The characteristics of each included study are presented in Table 1.
[Yes]

P19. Results / Risk of bias within studies
Quotes: "Two randomized controlled trial (Koivusalo [21] and Chan [17]), one nonrandomized clinical trial (Tsai [20]) and seven observational comparative studies (Niyogi [19]; Endo [22]; Bharathi [23, 28]; Hassan [24]; Koivusalo [25]; Oue [26]; Antao [27]) were assessed."
Reasoning: The results of the risk of bias assessments for individual studies are summarized.
[Yes]

P20. Results / Results of individual studies
Quotes: "Table 1 Comparative studies reporting laparoscopic inguinal hernia repair in infants and children"
Reasoning: Table 1 presents the key results for each individual study, but does not include effect estimates and confidence intervals.
[No]

P21. Results / Synthesis of results
Quotes: None relevant
Reasoning: A meta-analysis was not performed so there are no synthesis results to present.
[NA]

P22. Results / Risk of bias across studies
Quotes: None relevant
Reasoning: An assessment of risk of bias across studies is not reported, as a meta-analysis was not performed.
[NA]

P23. Results / Additional analysis
Quotes: "A sensitivity analysis was conducted where studies limited to girls, and/or with a median follow-up less than 6 months, and/or addressing a complicated hernia, and/or limited to infants were excluded and the meta-analysis of the remaining 6 comparative studies had shown a comparable recurrence rate among the groups [OR = 0.87; 95% CI 0.34–2.23; p = 0.76] (Fig. 2b)."
Reasoning: The results of the sensitivity analysis are reported.
[Yes]

P24. Discussion / Summary of evidence
Quotes: "Our review examined the safety and efficacy of the laparoscopic approach in the management of inguinal hernias in infants and children. Ten comparative studies were reviewed. Although the data is limited, the laparoscopic approach was associated with a trend towards higher recurrence rate."
Reasoning: The main findings are summarized in the discussion.
[Yes]

P25. Discussion / Limitations
Quotes: "Although our review utilized a very comprehensive search strategy to minimize the effect of publication bias, only two randomized clinical trial was included. Therefore, our review is a summary of the existing evidence with limitation to the conclusions drawn from these data due to the quality of the included studies."
Reasoning: Limitations at the review level are discussed.
[Yes]

P26. Discussion / Conclusions
Quotes: "Despite numerous case series spanning over a decade of surgical practice, only two randomized controlled trials were identified, studying 172 infants and children. The conflicting data revealed by the two randomized controlled trials could be explained partially by the possibility of selection bias and by the presence of potential confounding factors including different operative techniques and lack of standardization of other received treatments [17, 21]."
Reasoning: The conclusions provide a general interpretation of the results in the context of the evidence.
[Yes]

P27. Funding
Quotes: None relevant
Reasoning: Sources of funding for the systematic review are not described.
[No]

66. Apelt 2013: Laparoscopic treatment of intussusception in children: A systematic review

LLM response

15 quote(s) from publication full text (mean similarity 96.2%)

A1. Was an 'a priori' design provided?
Quotes: None relevant.
Reasoning: No mention of a protocol, ethics approval, or a priori objectives.
[No]

A2. Was there duplicate study selection and data extraction?
Quotes: None relevant.
Reasoning: No mention of duplicate study selection or data extraction.
[No]

A3. Was a comprehensive literature search performed?
Quotes: "An online database search for all English language articles on pediatric small bowel obstruction, intussusception and laparoscopy in PubMed, Medline and Ovid from January 1990 to April 2012 was performed."
Reasoning: At least 3 databases were searched but no supplementary sources mentioned.
[No]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
Quotes: None relevant.
Reasoning: No mention of including grey literature or unpublished studies.
[No]

A5. Was a list of studies (included and excluded) provided?
Quotes: None relevant.
Reasoning: No list of included or excluded studies provided.
[No]

A6. Were the characteristics of the included studies provided?
Quotes: "Table 1 Summary data of the selected studies included in the systematic review."
Reasoning: A table with key characteristics of included studies was provided.
[Yes]

A7. Was the scientific quality of the included studies assessed and documented?
Quotes: None relevant.
Reasoning: No assessment of study quality or risk of bias was mentioned.
[No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
Quotes: None relevant.
Reasoning: Study quality was not assessed (A7) so could not be incorporated into conclusions.
[No]

A9. Were the methods used to combine the findings of studies appropriate?
Quotes: "Owing to the absence of any randomized controlled trials and the heterogeneous nature of studies, a formal meta-analysis was not performed."
Reasoning: Appropriately did not perform meta-analysis due to lack of RCTs and study heterogeneity.
[Yes]

A10. Was the likelihood of publication bias assessed?
Quotes: None relevant.
Reasoning: Publication bias was not assessed.
[No]

A11. Was the conflict of interest included?
Quotes: None relevant.
Reasoning: Sources of funding for the systematic review and included studies were not reported.
[No]

P1. Title: Identify the report as a systematic review, meta-analysis, or both.
Quotes: "Laparoscopic treatment of intussusception in children: A systematic review"
Reasoning: The title identifies the article as a systematic review.
[Yes]

P2. Abstract / Structured summary
Quotes: The abstract contains labeled Background, Methods, Results, and Conclusion sections.
Reasoning: The abstract is structured with the key recommended sections.
[Yes]

P3. Introduction / Rationale
Quotes: "The use of laparoscopy in pediatric surgery has increased significantly in the past 20 years [4–6]. In children, recent meta-analyses comparing open to laparoscopic technique for interventions as diverse as appendectomy [7], splenectomy [8], pyloromyotomy [9] and pyeloplasty [10] have unanimously found a significantly reduced length of hospital stay, a better cosmetic result and a comparable or indeed reduced [9] complication rate using laparoscopy."
Reasoning: Provides rationale by discussing the increasing use and potential benefits of laparoscopy in pediatric surgery.
[Yes]

P4. Introduction / Objectives
Quotes: "We thus aimed to provide the data needed to challenge current clinical practice in favor of a method that allows for earlier discharge, reduced postoperative pain and decreased risk for postoperative SBO. To this end, we have performed a systematic review to assess the overall safety, success rate, complication rate and potential advantages in the laparoscopic treatment of pediatric intussusception."
Reasoning: Clearly states the objectives and key outcomes of interest for the review.
[Yes]

P5. Methods / Protocol and registration
Quotes: None relevant.
Reasoning: No mention of a protocol or registration number.
[No]

P6. Methods / Eligibility criteria
Quotes: "Exclusion criteria were non-English language articles, case reports, laparoscopic-assisted enema reduction and mixed pediatric and adult populations (age cutoff 18 years)."
Reasoning: Eligibility criteria related to study design, publication status, and population are provided.
[Yes]

P7. Methods / Information sources
Quotes: "An online database search for all English language articles on pediatric small bowel obstruction, intussusception and laparoscopy in PubMed, Medline and Ovid from January 1990 to April 2012 was performed."
Reasoning: Databases searched and dates of coverage are reported.
[Yes]

P8. Methods / Search
Quotes: "Likewise, the bibliographies of all articles identified by the search and shows the selection algorithm for the studies included."
Reasoning: The full search strategy is not presented for at least one database.
[No]

P9. Methods / Study selection
Quotes: "Fig. 1 Algorithm for the studies selection (based on PRISMA guidelines)."
Reasoning: A flow diagram of the study screening and selection process is provided.
[Yes]

P10. Methods / Data collection process
Quotes: None relevant.
Reasoning: The data extraction process is not described.
[No]

P11. Methods / Data items
Quotes: None relevant.
Reasoning: The variables for which data were sought are not defined.
[No]

P12. Methods / Risk of bias in individual studies
Quotes: None relevant.
Reasoning: No risk of bias assessment was mentioned.
[No]

P13. Methods / Summary measures
Quotes: None relevant.
Reasoning: Summary measures are not explicitly stated.
[No]

P14. Methods / Synthesis of results
Quotes: "Owing to the absence of any randomized controlled trials and the heterogeneous nature of studies, a formal meta-analysis was not performed."
Reasoning: Meta-analysis was not performed due to lack of RCTs and heterogeneity.
[NA]

P15. Methods / Risk of bias across studies
Quotes: None relevant.
Reasoning: Risk of bias across studies was not assessed.
[NA]

P16. Methods / Additional analyses
Quotes: None relevant.
Reasoning: No additional analyses were mentioned.
[NA]

P17. Results / Study selection
Quotes: "Fig. 1 Algorithm for the studies selection (based on PRISMA guidelines)."
Reasoning: A flow diagram with the number of studies at each stage is provided.
[Yes]

P18. Results / Study characteristics
Quotes: "Table 1 Summary data of the selected studies included in the systematic review."
Reasoning: A table of the characteristics of included studies is provided.
[Yes]

P19. Results / Risk of bias within studies
Quotes: None relevant.
Reasoning: Risk of bias of individual studies was not assessed.
[No]

P20. Results / Results of individual studies
Quotes: "Table 1 Summary data of the selected studies included in the systematic review."
Reasoning: Table 1 provides outcome data for each included study but not effect estimates and confidence intervals.
[No]

P21. Results / Synthesis of results
Quotes: "Owing to the absence of any randomized controlled trials and the heterogeneous nature of studies, a formal meta-analysis was not performed."
Reasoning: Meta-analysis was not performed.
[NA]

P22. Results / Risk of bias across studies
Quotes: None relevant.
Reasoning: Risk of bias across studies was not assessed.
[NA]

P23. Results / Additional analysis
Quotes: None relevant.
Reasoning: No additional analyses were reported.
[NA]

P24. Discussion / Summary of evidence
Quotes: "A large number of pediatric and general surgeons consider laparotomy to be the unequivocal gold standard in the surgical treatment of intussusception. Likewise, pediatric laparoscopy has been consistently associated with a significantly reduced length of stay compared to open surgery, regardless of primary pathology [7–10]. Even if the quality of data, about the difference in LOS between laparoscopic and open reduction of intussusception, is still weak, we believe that it is possible to speculate a shorter LOS after laparoscopy in light of the statistical significance obtained in Table 4 (4 vs. 7 days, p < 0.0001) and the previous pediatric laparoscopic literature [7–10]."
Reasoning: Summarizes key findings and their relevance to pediatric surgeons.
[Yes]

P25. Discussion / Limitations
Quotes: "Limitations of the present study includes the lack of prospective randomized controlled trials (RCT) comparing laparoscopic and open reduction of intussusception. In their absence or in the presence of technical difficulties, the threshold to convert to laparotomy should remain low with the aim to be safe and avoid complications."
Reasoning: Discusses limitations at the study level (lack of RCTs) and review level (technical difficulties leading to conversion).
[Yes]

P26. Discussion / Conclusions
Quotes: "In contrast, this systematic review showed laparoscopy to be safe and efficacious in the treatment of pediatric intussusception even responding to radiologic reduction. A laparoscopic success rate of more than 70% and a low rate of intraoperative (0.4%) and postoperative complications (2.9%) advocate for the use of laparoscopy as the primary surgical technique."
Reasoning: Provides an overall interpretation of the results in the context of laparoscopy as a treatment for pediatric intussusception.
[Yes]

P27. Funding
Quotes: None relevant.
Reasoning: Sources of funding for the systematic review are not reported.
[No]

67. Aworanti 2014: Management of Recurrent Tracheoesophageal Fistulas: A Systematic Review

LLM response

16 quote(s) from publication full text (mean similarity 99.9%)

A1. Was an 'a priori' design provided?
Quotes: None relevant.
Reasoning: No mention of a protocol, ethics approval, or a priori objectives.
[No]

A2. Was there duplicate study selection and data extraction?
Quotes: "All English language articles describing the management of RTEF in children were reviewed. A synthesis of the relevant data is presented in a descriptive form due to the heterogeneity of the included articles."
Reasoning: No mention of duplicate study selection or data extraction.
[No]

A3. Was a comprehensive literature search performed?
Quotes: "A Medline, Embase, and web of science searches were performed using the keywords recurrent tracheoesophageal fistula. The index of all issues of the European Journal of Pediatric Surgery, Journal of Pediatric Surgery, Pediatric Surgery International, and the International Journal of Pediatric Otorhinolaryngology was searched for relevant articles; the reference list of all relevant articles was also searched."
Reasoning: Searched 3 databases and reference lists, but no supplementary sources.
[No]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
Quotes: None relevant.
Reasoning: No mention of including grey literature or unpublished studies.
[No]

A5. Was a list of studies (included and excluded) provided?
Quotes: None relevant.
Reasoning: No list of included or excluded studies provided.
[No]

A6. Were the characteristics of the included studies provided?
Quotes: "A total of 165 cases of RTEF are described and there were 44 (26.7%) cases associated with anastomotic leaks while 35 (21.2%) were associated with anastomotic strictures preceding the diagnosis of RTEF."
Reasoning: Some aggregate characteristics of included studies provided, but not in table format.
[Yes]

A7. Was the scientific quality of the included studies assessed and documented?
Quotes: None relevant.
Reasoning: No assessment of study quality or risk of bias.
[No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
[NA] - No assessment of study quality was performed.

A9. Were the methods used to combine the findings of studies appropriate?
Quotes: "A synthesis of the relevant data is presented in a descriptive form due to the heterogeneity of the included articles."
Reasoning: Appropriately did not combine studies due to heterogeneity.
[Yes]

A10. Was the likelihood of publication bias assessed?
[NA] - No meta-analysis was performed.

A11. Was the conflict of interest included?
Quotes: "None."
Reasoning: Conflicts of interest statement provided for the review, but not for the included studies.
[No]

P1. Title
Quotes: "Management of Recurrent Tracheoesophageal Fistulas: A Systematic Review"
Reasoning: Identifies the article as a systematic review in the title.
[Yes]

P2. Abstract / Structured summary
Quotes: Entire abstract.
Reasoning: Provides a structured abstract with labeled sections covering background, materials and methods, results, and conclusion.
[Yes]

P3. Introduction / Rationale
Quotes: "The spectrum of esophageal atresia (EA) and tracheoesophageal fistula (TEF) include an isolated EA, EA with a proximal and/or distal TEF and the "H" or "N" type fistula. Since the initial description of the open surgical repair1 and subsequent thoracoscopic approaches2,3 the outcomes have been very encouraging. Anastomotic leaks, esophageal strictures, gastroesophageal reflux, and tracheomalacia are complications pediatric surgeons are familiar with. The incidence of a fistula recurrence range from 1.9 to 11% after open and thoracoscopic repairs.2,4–8 The diagnosis of these recurrent tracheoesophageal fistulas (RTEF) can often be elusive to the unsuspecting physician and the ideal approach to their management is still in debate."
Reasoning: Describes the rationale for the review in the context of what is already known about recurrent tracheoesophageal fistulas.
[Yes]

P4. Introduction / Objectives
Quotes: "We aim to comparatively review all published treatment options, and outcomes, for managing RTEF."
Reasoning: Provides an explicit statement of the review objective.
[Yes]

P5. Methods / Protocol and registration
Quotes: None relevant.
Reasoning: No mention of a review protocol or registration.
[No]

P6. Methods / Eligibility criteria
Quotes: "All English language articles published by August 2013, describing the management of RTEF in children were reviewed."
Reasoning: Specifies eligibility criteria of language, publication date, population and condition.
[Yes]

P7. Methods / Information sources
Quotes: "A Medline, Embase, and web of science searches were performed using the keywords recurrent tracheoesophageal fistula. The index of all issues of the European Journal of Pediatric Surgery, Journal of Pediatric Surgery, Pediatric Surgery International, and the International Journal of Pediatric Otorhinolaryngology was searched for relevant articles; the reference list of all relevant articles was also searched."
Reasoning: Describes the databases searched and the journals hand-searched.
[Yes]

P8. Methods / Search
Quotes: "A Medline, Embase, and web of science searches were performed using the keywords recurrent tracheoesophageal fistula."
Reasoning: Provides the search terms used but not the full search strategy.
[No]

P9. Methods / Study selection
Quotes: "All English language articles describing the management of RTEF in children were reviewed."
Reasoning: States the process for selecting studies based on the eligibility criteria.
[Yes]

P10. Methods / Data collection process
Quotes: None relevant.
Reasoning: No description of the data extraction process.
[No]

P11. Methods / Data items
Quotes: None relevant.
Reasoning: Variables for which data were sought are not defined.
[No]

P12. Methods / Risk of bias in individual studies
Quotes: None relevant.
Reasoning: No assessment of risk of bias in individual studies.
[No]

P13. Methods / Summary measures
[NA] - No meta-analysis was performed.

P14. Methods / Synthesis of results
[NA] - No meta-analysis was performed.

P15. Methods / Risk of bias across studies
[NA] - No meta-analysis was performed.

P16. Methods / Additional analyses
[NA] - No meta-analysis was performed.

P17. Results / Study selection
Quotes: "A total of 44 papers between 1955 and 2013 described 165 patients; 57 ET and 108 OS. Of the 57 ET patients, there was an 84% success rate compared with 93.5% of 108 OS patients; the failed ET cases were all successfully treated by OS."
Reasoning: Provides the number of studies and patients included, but no flow diagram or reasons for exclusions.
[No]

P18. Results / Study characteristics
Quotes: See Table 2.
Reasoning: Study characteristics are provided for each included study.
[Yes]

P19. Results / Risk of bias within studies
[NA] - No assessment of risk of bias was performed.

P20. Results / Results of individual studies
Quotes: See Tables 1-4.
Reasoning: Results are provided for individual studies and groups.
[Yes]

P21. Results / Synthesis of results
[NA] - No meta-analysis was performed.

P22. Results / Risk of bias across studies
[NA] - No assessment of risk of bias across studies was performed.

P23. Results / Additional analysis
[NA] - No additional analyses were performed.

P24. Discussion / Summary of evidence
Quotes: "OS for RTEF has a low morbidity and mortality, a higher success rate, and requires fewer treatments than an endoscopic repair. The ideal ET is undecided but it remains a viable alternative provided treatment failures are anticipated and prompt redo treatments initiated to prevent ongoing respiratory morbidity."
Reasoning: Summarizes the main findings and their relevance to key groups.
[Yes]

P25. Discussion / Limitations
Quotes: "The major complications after OS were 17 (16%) leaks and 4 (3.7%) deaths; while for ET 3 (5%) suffered respiratory distress postoperatively and there was 1 (1.7%) death reported in 2005; this occurred 3 days postprocedure and the cause was unspecified."
Reasoning: Discusses some limitations at the study level but not at the review level.
[No]

P26. Discussion / Conclusions
Quotes: "Minimally invasive techniques are widely accepted to be better tolerated by patients and whenever possible such options should be explored, thus supporting the case for ET; however, the outcomes should be comparable. Several authors have used a variety of techniques for ET, summarized above, all hoping to achieve better outcomes. There have been three literature reviews on ET. In Hoelzer 1999 review,12 15 cases were reported, having been treated with diathermy, laser, n-BCA, and fibrin glue, and 1 to 5 treatments were necessary with complete closure in only 10 patients (67%). Meier et al in 200726 reported an overall success rate of 60% of 62 patients culled from the literature (fibrin glue 55% [n = 22], n-BCA 48% [n = 29], laser 80% [n = 5], diathermy 50% [n = 10], n-BCA + sclerosant100% [n = 5]); the mean number of applications ranged from 1 to 5.5. They concluded that ET is safe, effective, has less morbidity than OS and recommended fibrin glue but advised close follow-up. Richter et al28 in their 2008 review, culled 37 patients from the literature and categorized ET into: application of sealant only (n = 14; 78.6% success), de-epithelialization of the fistula tract only (n = 8; 62.5% success), de-epithelialization combined with sealant (n = 15; 93.3%). Overall there was an 81.1% success rate (48.6% after a single attempt) and they concluded that de-epithelialization with diathermy combined with fibrin glue sealant will yield the best results; fibrin glue by nature would work better if the opposing surfaces are closely apposed and not epithelialized.21 The failures seen with ET may be partly because the sealants fibrin glue and n-BCA are biodegradable. Aproninin, an antifibrinolytic, prolongs the stability of fibrin glue in vivo for up to 10 days only96; however, the fibrin clot formed has a loose scaffold that encourages in-growth of fibroblasts. n-BCA, commonly used for skin closure, is not recommended for mucosal application by most manufacturers, as its stability and possible absorption in such environments is not yet fully determined. Willets et al (1998)55 also appreciating the possibility of late refistulation after ET, and the limited follow-up period of the reported cases managed endoscopically, decided to evaluate the long-term outcome of these patients by contacting the respective authors. They concluded that of 22 patients initially reported to have had successful ET, only 12 (55%) remained closed after a median follow-up of 107 months; there was however no morbidity or mortality directly related to these procedures."
Reasoning: Provides a general interpretation of the results in the context of other evidence and implications for future research.
[Yes]

P27. Funding
Quotes: "None."
Reasoning: Sources of funding for the systematic review are reported.
[Yes]

68. Baker 2015: A systematic review and meta-analysis of gastrostomy insertion techniques in children

LLM response

24 quote(s) from publication full text (mean similarity 98.5%)

A1. Was an 'a priori' design provided?
Quotes: None relevant.
Reasoning: The article does not mention a protocol, ethics approval, or pre-determined research objectives.
[No]

A2. Was there duplicate study selection and data extraction?
Quotes: "Data extraction was conducted by 2 reviewers (LB & AB) using a predefined data extraction worksheet."
Reasoning: Two reviewers conducted data extraction, but duplicate study selection is not mentioned.
[No]

A3. Was a comprehensive literature search performed?
Quotes: "A systematic search of electronic databases was performed to identify all relevant studies comparing two or more gastrostomy insertion techniques in children reporting procedural-related complication rates. A reference librarian was consulted to assist with the development of database-specific search strategies. We used exploded Medical Subject Headings (MeSH) and keywords to search for the following themes: pediatrics, open gastrostomy, percutaneous endoscopic gastrostomy, interventional radiologically guided gastrostomy, and laparoscopic gastrostomy (Appendix 1 for detailed search strategy). We applied the search strategy to the following databases: MEDLINE (PubMed, PubMIsd in Process and Ovid), EMBASE, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Scopus and Cochrane Library."
Reasoning: Multiple electronic databases were searched using a comprehensive search strategy developed with a librarian.
[Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
Quotes: None relevant.
Reasoning: The article does not mention searching for grey literature or unpublished studies.
[No]

A5. Was a list of studies (included and excluded) provided?
Quotes: "Fig. 1. Consort diagram of articles included in review."
Reasoning: A flow diagram is provided showing the number of studies included and excluded at each stage.
[Yes]

A6. Were the characteristics of the included studies provided?
Quotes: "Table 1 Studies that met inclusion criteria, segregated by procedure. Complication rates and MINORS score are displayed."
Reasoning: Key characteristics of the included studies are provided in an aggregated table.
[Yes]

A7. Was the scientific quality of the included studies assessed and documented?
Quotes: "The methodological index for non-randomized studies (MINORS) was utilized to determine the quality of each of the included studies."
Reasoning: The MINORS tool was used to assess the quality of included studies, with scores reported in Table 1.
[Yes]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
Quotes: "Considerable variation existed in reporting practices of enteral feeding tube gastrostomy insertion. Five studies evaluated this outcome, with three studies demonstrating significantly improved feeding parameters when comparing lap to open GT insertion [3,21,33,34,37]."
Reasoning: The variable quality of studies was considered when interpreting results and drawing conclusions.
[Yes]

A9. Were the methods used to combine the findings of studies appropriate?
Quotes: "The studies not described either failed to report a statistical analysis or did not comment on the above patient demographics."
Reasoning: Quantitative synthesis was not performed, likely due to heterogeneity of studies. This is appropriate for this review.
[NA]

A10. Was the likelihood of publication bias assessed?
Quotes: None relevant.
Reasoning: Publication bias was not assessed, which is appropriate since no quantitative synthesis was performed.
[NA]

A11. Was the conflict of interest included?
Quotes: "We would like to thank Robin Featherstone from the McGill Faculty of Medicine Library for her assistance with the literature search and the retrieval of articles."
Reasoning: Sources of support for the review are acknowledged, but not for the individual included studies.
[No]

P1. Title
Quotes: "A systematic review and meta-analysis of gastrostomy insertion techniques in children"  
Reasoning: The title identifies the article as a systematic review and meta-analysis.
[Yes]

P2. Abstract / Structured summary
Quotes: The abstract contains labeled sections for Background, Methods, Results, and Conclusions.
Reasoning: A structured abstract is provided with the required sections.
[Yes]

P3. Introduction / Rationale  
Quotes: "Gastrostomy tubes are inserted via multiple techniques to provide a route for enteral feeding in the pediatric population. This review compares the rate of major complications and resource utilization associated with the various insertion techniques."
Reasoning: The rationale for the review is described in the context of current knowledge.
[Yes]

P4. Introduction / Objectives
Quotes: "The primary outcome of interest was postoperative complication resulting in death or requiring operative management within one year - our working definition of a major complication."
Reasoning: The primary outcome of interest is clearly stated, but the full PICOS are not provided.
[No]

P5. Methods / Protocol and registration
Quotes: None relevant.
Reasoning: No mention of a review protocol or registration.
[No]

P6. Methods / Eligibility criteria
Quotes: "All studies that compared postoperative outcomes in two or more gastrostomy placement techniques in a pediatric population were included. The primary outcome of interest was postoperative complication resulting in death or requiring operative management within one year - our working definition of a major complication."
Reasoning: Eligibility criteria for population, interventions, comparators, and primary outcome are provided, but not for study designs or other characteristics.
[No]

P7. Methods / Information sources
Quotes: "We applied the search strategy to the following databases: MEDLINE (PubMed, PubMIsd in Process and Ovid), EMBASE, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Scopus and Cochrane Library. The search was restricted temporally from 1993 to 2013, with no linguistic restriction."
Reasoning: Electronic databases searched and dates of coverage are described.
[Yes]

P8. Methods / Search
Quotes: "Appendix 1. Detailed search strategy for each database"
Reasoning: The full search strategy for multiple databases is provided in the appendix.
[Yes]

P9. Methods / Study selection
Quotes: "All titles and abstracts identified in the electronic database were independently screened for relevance and categorized as relevant, possibly relevant or irrelevant, based on our inclusion criteria. Manuscripts of articles categorized as either relevant or possibly relevant were retrieved for further evaluation."
Reasoning: The process for study selection is described.
[Yes]

P10. Methods / Data collection process
Quotes: "Data extraction was conducted by 2 reviewers (LB & AB) using a predefined data extraction worksheet. The following information was extracted from each article: title, authors, number of centers involved,"
Reasoning: Data extraction was performed in duplicate using a predefined form.
[Yes]

P11. Methods / Data items
Quotes: None relevant.
Reasoning: Variables for which data were sought are not explicitly defined.
[No]

P12. Methods / Risk of bias in individual studies
Quotes: "The methodological index for non-randomized studies (MINORS) was utilized to determine the quality of each of the included studies."
Reasoning: The MINORS tool was used to assess risk of bias in individual studies.
[Yes]

P13. Methods / Summary measures
Quotes: None relevant. 
Reasoning: Summary measures are not specified, as no quantitative synthesis was performed.
[NA]

P14. Methods / Synthesis of results
Reasoning: No quantitative synthesis was performed.
[NA]

P15. Methods / Risk of bias across studies
Reasoning: Risk of bias across studies was not assessed, as is appropriate since no quantitative synthesis was performed.
[NA]  

P16. Methods / Additional analyses
Reasoning: No additional analyses were reported.
[NA]

P17. Results / Study selection
Quotes: "Fig. 1. Consort diagram of articles included in review."
Reasoning: A flow diagram is provided detailing the study selection process with numbers at each stage.
[Yes]

P18. Results / Study characteristics
Quotes: "Table 1 Studies that met inclusion criteria, segregated by procedure. Complication rates and MINORS score are displayed."
Reasoning: Study characteristics are provided in Table 1.
[Yes]

P19. Results / Risk of bias within studies
Quotes: "The methodological index for non-randomized studies (MINORS) was utilized to determine the quality of each of the included studies."
Reasoning: MINORS scores assessing risk of bias are reported for each included study in Table 1.
[Yes]

P20. Results / Results of individual studies
Quotes: "Table 2 Comparison of studies investigating laparoscopic gastrostomy versus percutaneous endoscopic gastrostomy."
Reasoning: Results for individual studies are provided in Table 2, but no effect estimates or confidence intervals are reported.
[No]

P21. Results / Synthesis of results
Reasoning: No quantitative synthesis was performed.
[NA]

P22. Results / Risk of bias across studies
Reasoning: Risk of bias across studies was not assessed.
[NA]

P23. Results / Additional analysis
Reasoning: No additional analyses were reported.
[NA]

P24. Discussion / Summary of evidence
Quotes: "Gastrostomy tube placement remains a highly popular intervention with a number of indications, in both adult and pediatric populations. Since initially introduced in 1986 as an open surgical approach, it has evolved into a procedure performed using multiple different techniques by several different operators, including surgeons, gastroenterestinal endoscopists and interventional radiologists."
Reasoning: The main findings are summarized, considering their relevance to key stakeholders.
[Yes]

P25. Discussion / Limitations
Quotes: "Selection of older, heavier children for the open procedure may be explained by the lack of evidence documenting safety of PEG in infants at the time of study completion. The first large pediatric review reporting safety of PEG in small (<6 kg) neonates with failure to thrive was in 2011 [38]. As there is currently no literature supporting patient age or weight as a predictive factor for success and safety of tube placement, we are unable to draw conclusions on the influence of these discrepancies of baseline demographics on the results. Additionally, the other 7 studies failed to report patient demographic information."
Reasoning: Limitations at the study and review level are discussed.
[Yes]

P26. Discussion / Conclusions
Quotes: "The placement of a gastrostomy tube in a pediatric patient often represents a seminal moment for the child, his/her family and the medical team providing care. The implications of the procedure resonate for years to follow as care plans shift to outpatient management and nutritional needs become definitively addressed. Ultimately, the technique chosen for gastrostomy tube placement should rest with the implicated health care team, individualized for each unique patient circumstance and be based on individual/institutional expertise."
Reasoning: The conclusions provide a general interpretation of the results with implications for practice.
[Yes]

P27. Funding
Quotes: "We would like to thank Robin Featherstone from the McGill Faculty of Medicine Library for her assistance with the literature search and the retrieval of articles."
Reasoning: Sources of support for the review are acknowledged, but funding sources for the individual studies are not reported.
[No]

69. Berger 2012: Mitomycin C in the Therapy of Recurrent Esophageal Strictures: Hype or Hope?

LLM response

20 quote(s) from publication full text (mean similarity 97.1%)

A1 - Was an 'a priori' design provided?
Quote: "The current literature was screened for publications regarding the application of Mitomycin C in esophageal stenosis and stricture with special emphasis on pediatric data."
The authors describe their literature search methods, but do not mention an a priori protocol or pre-specified objectives.
[No]

A2 - Was there duplicate study selection and data extraction? 
No quotes identified. The authors do not mention any procedures for duplicate study selection or data extraction.
[No]

A3 - Was a comprehensive literature search performed?
Quote: "The screen included the use of Mitomycin C in other subspecialties such as ophthalmology; ear, nose, and throat surgery; as well as animal models."
The authors searched multiple subspecialties and animal models, indicating a comprehensive search, but do not provide details on databases, years, keywords, or supplementary strategies.
[No]

A4 - Was the status of publication (i.e. grey literature) used as an inclusion criterion?
No quotes identified. The authors do not specify whether they included or excluded studies based on publication type.
[No]  

A5 - Was a list of studies (included and excluded) provided?
Quote: "Values in parentheses represent the mean."
The authors report the number of studies analyzed but do not provide a list of the included and excluded studies.
[No]

A6 - Were the characteristics of the included studies provided?
Quote: "Table 2 Overview on Existing Literature—Patient's Age, Etiology, and Morphology of Esophageal Stricture and Stenosis"
The authors provide an aggregated table of key characteristics of the included studies.
[Yes]

A7 - Was the scientific quality of the included studies assessed and documented?
No quotes identified. The authors do not report assessing the quality of individual studies.
[No]

A8 - Was the scientific quality of the included studies used appropriately in formulating conclusions?
Not applicable, as study quality was not assessed (A7).
[NA]

A9 - Were the methods used to combine the findings of studies appropriate? 
Not applicable, as this review does not appear to include a quantitative synthesis or meta-analysis.
[NA]

A10 - Was the likelihood of publication bias assessed?
Not applicable, as this review does not include a quantitative synthesis.
[NA]

A11 - Was the conflict of interest included?
Quote: "M. Berger was supported by the German Academic Exchange Service (DAAD, Deutscher Akademischer Austauschdienst)."
The authors report a funding source for the review but do not report funding sources for each included study.
[No]

P1 - Title: Identify the report as a systematic review, meta-analysis, or both.
Quote: "Mitomycin C in the Therapy of Recurrent Esophageal Strictures: Hype or Hope?"  
The title does not identify the article as a systematic review or meta-analysis.
[No]

P2 - Abstract: Structured summary
Quote: "Abstract Introduction Esophageal strictures refractory to conservative treatment represent a major problem in children. The application of Mitomycin C to the site of stricture has been introduced, but the experience with this novel approach remains very limited. Methods Systematic review of publications on the topical application of Mitomycin C in children with persistent esophageal stricture. Results We identified 11 publications including 31 cases."
The abstract has distinct labeled sections for Introduction, Methods, and Results.
[Yes] 

P3 - Introduction: Rationale
Quote: "For centuries, esophageal strictures have been recognized as an important health problem in children.1–3 The etiology includes surgery for malformations of the foregut such as esophageal atresia (EA) and tracheoesophageal fistula (TEF), the ingestion of caustic agents, severe gastroesophageal reflux, and other disease entities."
The introduction describes the background and rationale for the review.
[Yes]

P4 - Introduction: Objectives
Quote: "The traditional initial treatment of esophageal strictures is intraluminal dilation. Different methods to achieve adequate luminal dimension have been described including Tucker's dilators, Savary-Gillard bougies or Eder-Puestow metal olives,"
The introduction discusses treatment of esophageal strictures but does not provide an explicit statement of the review questions and PICOS elements.
[No]

P5 - Methods: Protocol and registration
No quotes identified. The authors do not mention a review protocol or registration number.
[No]

P6 - Methods: Eligibility criteria
Quote: "The screen included the use of Mitomycin C in other subspecialties such as ophthalmology; ear, nose, and throat surgery; as well as animal models. Data were collected on the patient population treated, indication, description of stricture, technique of application, dosage, number of and interval between applications, complications, and outcome."
The authors specify the study characteristics and report characteristics used as eligibility criteria.
[Yes]

P7 - Methods: Information sources
Quote: "The current literature was screened for publications regarding the application of Mitomycin C in esophageal stenosis and stricture with special emphasis on pediatric data."
The authors describe the information sources searched but do not provide specific databases or dates.
[No]

P8 - Methods: Search
No quotes identified. The authors do not present the full search strategy for any database.
[No]

P9 - Methods: Study selection
Quote: "We identified 11 publications including 31 cases."
The authors report the number of included studies and cases but do not describe the process for selecting studies.
[No]

P10 - Methods: Data collection process
No quotes identified. The authors do not describe the method of data extraction.
[No]

P11 - Methods: Data items
Quote: "Data were collected on the patient population treated, indication, description of stricture, technique of application, dosage, number of and interval between applications, complications, and outcome."
The authors list the data items collected.
[Yes]

P12 - Methods: Risk of bias in individual studies
No quotes identified. The authors do not describe methods for assessing risk of bias in individual studies.
[No]

P13 - Methods: Summary measures
No quotes identified. The authors do not state the principal summary measures.
[No]  

P14 - Methods: Synthesis of results
Not applicable, as no meta-analysis was conducted.
[NA]

P15 - Methods: Risk of bias across studies 
Not applicable, as no meta-analysis was conducted.
[NA]

P16 - Methods: Additional analyses
Not applicable, as no meta-analysis was conducted.
[NA]

P17 - Results: Study selection
Quote: "We identified 11 publications including 31 cases."  
The authors report the total number of included studies and cases but do not provide a flow diagram with reasons for exclusions at each stage.
[No]

P18 - Results: Study characteristics
Quote: "Table 2 Overview on Existing Literature—Patient's Age, Etiology, and Morphology of Esophageal Stricture and Stenosis"
The authors provide a table of characteristics for each included study with citations.
[Yes]

P19 - Results: Risk of bias within studies
Not applicable, as risk of bias was not assessed (P12).  
[NA]

P20 - Results: Results of individual studies
Quote: "Table 1 displays the variety of Mitomycin C application. By combining the keyword "Mitomycin C" with "eye" or "airway" more than 1400 PubMed publications were detected."
The authors provide some summary data for individual studies in tables but do not include effect estimates and confidence intervals for all outcomes.
[No]

P21 - Results: Synthesis of results
Not applicable, as no meta-analysis was conducted.
[NA]

P22 - Results: Risk of bias across studies
Not applicable, as no meta-analysis was conducted.
[NA] 

P23 - Results: Additional analysis
Not applicable, as no additional analyses were reported.
[NA]

P24 - Discussion: Summary of evidence
Quote: "The early results of topical Mitomycin C application for the treatment of severe, recurrent esophageal strictures refractory to repeated balloon dilations are encouraging. The application of Mitomycin C, at short follow-up, was shown to be safe, and no complications or dysplasia were acknowledged."
The authors summarize the main findings and their relevance.
[Yes]

P25 - Discussion: Limitations
Quote: "Although the etiology causing the stenosis was very heterogeneous, all children were homogenous in that repeated dilations did not show improvement and that none had previously been treated with Mitomycin C."
The authors acknowledge limitations regarding the heterogeneity of etiologies and lack of prior Mitomycin C treatment.
[Yes]

P26 - Discussion: Conclusions
Quote: "Several aspects should be considered when interpreting these results. All cases had severe esophageal strictures refractory to repeated dilations. In this patient population, any minor improvement must be appreciated as a success."
The authors provide a general interpretation and implications for future research.
[Yes]

P27 - Funding
Quote: "M. Berger was supported by the German Academic Exchange Service (DAAD, Deutscher Akademischer Austauschdienst)."
The authors describe a funding source for the review but not for individual studies.
[No]

70. Billingham 2010: Pediatric Surgical Technique: Laparoscopic or Open Approach? A systematic Review and Meta-Analysis

LLM response

24 quote(s) from publication full text (mean similarity 99.2%)

A1 - Was an 'a priori' design provided?
Quote: "A computerized comprehensive search supplemented by a manual review of the literature was performed for all peer-reviewed publications comparing laparoscopic and open appendectomy, fundoplication and hernia repair cohorts."
The authors mention performing a comprehensive literature search, but do not specify an a priori protocol or predetermined objectives.
[No]

A2 - Was there duplicate study selection and data extraction? 
Quote: "A total of 24 articles were identified that met the search and inclusion criteria."
The authors do not mention any duplicate study selection or data extraction process.
[No]

A3 - Was a comprehensive literature search performed?
Quote: "To complete this study a comprehensive literature review was conducted. All available electronic databases including the British Nursing Index (BNI), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, EMBASE (Excerpta Medica), Intute: Health & Life Sciences, MEDLINE, PubMed, BIOSIS Previews, ISI Web of Knowledge, ISI Web of Science and IngentaConnect, were systematically searched for each procedure, between the period 1992–2009 for all English and non-English language articles."
The authors searched a comprehensive set of databases over a wide date range.
[Yes]

A4 - Was the status of publication (i.e. grey literature) used as an inclusion criterion?
The authors do not mention including or excluding studies based on publication status or grey literature.
[No]

A5 - Was a list of studies (included and excluded) provided?
The authors provide a table (Table 1) listing the 24 included studies, but do not provide a list of excluded studies.
[No]

A6 - Were the characteristics of the included studies provided?
Quote: "The study design and methodological quality of the included studies are summarized in Table 1."
Table 1 provides key characteristics of the included studies like procedure type, sample sizes, study design, and quality score.
[Yes]

A7 - Was the scientific quality of the included studies assessed and documented?
Quote: "The study design and methodological quality of the included studies are summarized in Table 1."
Table 1 includes a "Study Quality" column assessing the quality of each included study on a scale of 1-2.
[Yes] 

A8 - Was the scientific quality of the included studies used appropriately in formulating conclusions?
The authors do not appear to consider the quality assessments when discussing the results or formulating conclusions.
[No]

A9 - Were the methods used to combine the findings of studies appropriate?
Quote: "Meta-analysis was conducted using weighted mean differences (WMD) as the summary statistic, comparing the laparoscopic treatment groups with the reference (open surgery) groups using the Mantel-Haenszel method."
The authors used appropriate meta-analytic methods to combine the results.
[Yes]

A10 - Was the likelihood of publication bias assessed?
The authors do not mention assessing publication bias.
[No]

A11 - Was the conflict of interest included?
The authors do not provide any conflict of interest disclosures for the systematic review itself or the included studies.
[No]

P1 - Title: Identify the report as a systematic review, meta-analysis, or both.
Quote: "Pediatric Surgical Technique: Laparoscopic or Open Approach? A systematic Review and Meta-Analysis"
The title identifies the article as both a systematic review and meta-analysis.
[Yes]

P2 - Abstract / Structured summary
The abstract is structured with labeled sections for Introduction, Method/Design, Results, and Conclusion, summarizing the key aspects of the review.
[Yes]

P3 - Introduction / Rationale
Quote: "As in adult surgery, laparoscopy has become an integral part of pediatric surgical practice [6–8,18]. One study in 1998 surveyed pediatric surgeons in the United States and Canada to determine the extent of incorporation of laparo-"
The introduction provides rationale by discussing the increasing use of laparoscopy in pediatric surgery.
[Yes]

P4 - Introduction / Objectives
Quote: "The laparoscopic treatment of pediatric populations remains controversial. In order to evaluate the clinical and cost-effectiveness of this surgical approach a number of outcome measures for"
The introduction states the objectives of evaluating clinical and cost-effectiveness of the laparoscopic approach.
[Yes]

P5 - Methods / Protocol and registration
The authors do not mention a pre-registered protocol.
[No]

P6 - Methods / Eligibility criteria
Quote: "Inclusion criteria: Prospective randomized or prospective non-randomized study format only. Operative results reported for a "pediatric population", using the words "children, infants or neonates" to describe the study group and including infants, neonates or children (or combinations of the three). Study subjects under 17 years of age only. Comparison of laparoscopic and open techniques."
The authors specify the inclusion criteria in terms of study design, population, and intervention.
[Yes]

P7 - Methods / Information sources
Quote: "To complete this study a comprehensive literature review was conducted. All available electronic databases including the British Nursing Index (BNI), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, EMBASE (Excerpta Medica), Intute: Health & Life Sciences, MEDLINE, PubMed, BIOSIS Previews, ISI Web of Knowledge, ISI Web of Science and IngentaConnect, were systematically searched for each procedure, between the period 1992–2009 for all English and non-English language articles."
The authors list the databases searched and date ranges.
[Yes]

P8 - Methods / Search
The authors state the databases searched but do not provide the full search strings to allow replication.
[No]

P9 - Methods / Study selection
Quote: "A total of 24 articles were identified that met the search and inclusion criteria."
The number of included studies is provided but the selection process is not described in detail.
[No]

P10 - Methods / Data collection process
The data extraction process is not described.
[No]

P11 - Methods / Data items
Quote: "laparoscopic and open techniques were analyzed in a comparative fashion. These outcome measures included: Length of stay (LOS) after the procedure, Operating room (OR) time, Frequency of postoperative complications and Total hospital costs."
The authors list the data items collected from studies.
[Yes]

P12 - Methods / Risk of bias in individual studies
Quote: "The study design and methodological quality of the included studies are summarized in Table 1."
The authors assessed study quality on a 1-2 scale as shown in Table 1.
[Yes]

P13 - Methods / Summary measures
Quote: "Meta-analysis was conducted using weighted mean differences (WMD) as the summary statistic"
The weighted mean difference is specified as the effect measure.
[Yes]

P14 - Methods / Synthesis of results
Quote: "Meta-analysis was conducted using weighted mean differences (WMD) as the summary statistic, comparing the laparoscopic treatment groups with the reference (open surgery) groups using the Mantel-Haenszel method."
The meta-analysis methods are described.
[Yes]

P15 - Methods / Risk of bias across studies
Assessment of bias across studies like publication bias is not mentioned.
[No]

P16 - Methods / Additional analyses
The authors do not describe any additional analyses.
[No]

P17 - Results / Study selection
Quote: "A total of 24 articles were identified that met the search and inclusion criteria."
The number of included studies is provided but a full study flow diagram is not included.
[No]

P18 - Results / Study characteristics
Quote: "The study design and methodological quality of the included studies are summarized in Table 1."
Table 1 provides the key characteristics of each included study.
[Yes]

P19 - Results / Risk of bias within studies
Quote: "The study design and methodological quality of the included studies are summarized in Table 1."
The 1-2 quality scores for each study are provided in Table 1.
[Yes]

P20 - Results / Results of individual studies
The results of individual studies are not reported, only the pooled meta-analysis results are provided.
[No]

P21 - Results / Synthesis of results
Quotes: "Fig. 1 Forest plot of length of stay ratio meta-analysis." "Fig. 2 Forest plot of operating room time ratio meta-analysis." "Fig. 3 Forest plot of total cost ratio meta-analysis."
The meta-analysis results are reported with forest plots and confidence intervals.
[Yes]

P22 - Results / Risk of bias across studies
Assessment of bias across studies is not reported.
[No]

P23 - Results / Additional analysis
No additional analyses are reported.
[No]

P24 - Discussion / Summary of evidence
Quote: "LOS and OR times: Fig. 1, 2 present the comprehensive analysis of all 24 studies, with study specific mean differences and overall LOS and OR weighted mean differences. Clearly, LOS is significantly reduced in favor of the laparoscopic approach, with an overall weighted mean difference for LOS of -1.44 days (95% CI, -1.89 to -0.99, p<0.001), although the OR time is significantly increased, with a weighted mean difference of +12.8 min (95% CI, +3.7 to +21.9, p=0.006), favoring the open surgical technique."
The authors summarize the key findings for the main outcomes.
[Yes]

P25 - Discussion / Limitations
Quote: "The validity of the results of this review largely depends on the validity of the included studies. Many of the included studies failed to take all the steps necessary to avoid bias. There may well be an inherent bias in the analyses, which are likely to favor the 'newer' MIS/laparoscopic technique. The study will tend to select series performed by surgeons confident with MIS, whose results may not be suitable for generalizations. Those less confident/happier with conventional techniques may fare better doing 'what they know'. The only way of ensuring confidence in our findings would be by only including combination trials (ideally crossover). Conclusions are, therefore, limited by the quality of the included studies and the information provided."
The authors discuss several important limitations of the review.
[Yes]

P26 - Discussion / Conclusions
Quote: "This review strengthens the use of MIS in pediatric populations, demonstrating that the three laparoscopic procedures reviewed showed better patient outcomes compared to open procedures in the form of reduced LOS and complication rates."
The authors provide an overall conclusion interpreting the results.
[Yes]

P27 - Funding
No funding sources are reported for the systematic review.
[No]

71. Black 2013: Bariatric surgery for obese children and adolescents: a systematic review and meta-analysis

LLM response

20 quote(s) from publication full text (mean similarity 99.6%)

A1. Was an 'a priori' design provided?
Quotes: None relevant.
Reasoning: No mention of a protocol, ethics approval, or a priori objectives.
[No]

A2. Was there duplicate study selection and data extraction?
Quotes: "Two additional papers were retrieved during full text screening. One potentially relevant paper could not be sourced (24), and one was collected via contacting the author (25)."
Reasoning: Duplicate study selection is mentioned for full text screening, but not for abstract screening or data extraction.
[No]

A3. Was a comprehensive literature search performed?
Quotes: "The indexed reference libraries EMBASE and Medline were searched between January 1955 and January 2013 using the search terms presented in Table 1, using mapped and exploded terms. Additionally, the references of all included studies, the Cochrane Library and the titles of papers published in the journal Obesity Surgery from January 1992 till January 2013 were searched. Only papers written in English were retrieved."
Reasoning: At least 2 databases plus reference checking were searched.
[Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
Quotes: None relevant.
Reasoning: No mention of including grey literature or unpublished studies.
[No]

A5. Was a list of studies (included and excluded) provided?
Quotes: "A total of 2303 unique citations were returned by the search strategy (Fig. 1). Of these, 2185 were excluded based on abstract review. Two additional papers were retrieved during full text screening. One potentially relevant paper could not be sourced (24), and one was collected via contacting the author (25)."
Reasoning: A flow diagram is provided with reasons for exclusions, but no list of excluded studies.
[No]

A6. Were the characteristics of the included studies provided?
Quotes: "The median number of patients at baseline in each study was 24 (range 10-130). In total, 637 patients were analysed at post-surgery follow-up. All 23 studies included a greater proportion of women than men (range 51-81%). Pre-surgery BMI was similar for surgery types, although was highest in RYGB studies (median pre-surgery BMI in RYBG, AGB and SG: 52.4, 46.1 and 49.6, respectively). Seven RYGB, 11 AGB studies and 3 SG studies were sourced."
Reasoning: Aggregate characteristics of the included studies are provided.
[Yes]

A7. Was the scientific quality of the included studies assessed and documented?
Quotes: None relevant.
Reasoning: No mention of assessing study quality or risk of bias.
[No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
[NA] - Quality was not assessed (A7).

A9. Were the methods used to combine the findings of studies appropriate?
Quotes: "Formulas outlined in the Cochrane Guidelines were used to derive necessary statistics or process individual data from each of the studies included in the meta-analysis (20). Median BMI estimates were not included in our review as variances are needed to meta-analyse data."
Reasoning: Appropriate methods were used to combine the studies in meta-analysis.
[Yes]

A10. Was the likelihood of publication bias assessed?
Quotes: None relevant. 
Reasoning: Publication bias was not assessed.
[No]

A11. Was the conflict of interest included?
Quotes: "No conflict of interest was declared."
Reasoning: Conflicts of interest were reported for the systematic review but not for the individual studies.
[No]

P1. Title
Quotes: "Bariatric surgery for obese children and adolescents: a systematic review and meta-analysis"
Reasoning: The title identifies the article as a systematic review and meta-analysis.
[Yes]

P2. Abstract / Structured summary
Quotes: The abstract contains labeled sections for Summary, Keywords, and Introduction.
Reasoning: The abstract is structured with background, objectives, data sources, study eligibility criteria, participants, study appraisal and synthesis methods, results, limitations, and conclusions.
[Yes]

P3. Introduction / Rationale
Quotes: "The global prevalence of obesity is rising in children and adolescents (1). In the United Kingdom, e.g. among individuals aged 11-15 years, the prevalence was 14.7% in 1995 and 18.3% in the 2010 round of the National Child Measurement Programme (2). The largest increases in body mass index (BMI) are seen in the top 5% of the BMI distribution (3). Treatment guidelines for obese children from National Institute for Health and Clinical Excellence (NICE) recommend lifestyle intervention support, assessment of co-morbidities, and referral to secondary care if morbidities are present (3,4). Children and adolescents for whom lifestyle change and standard clinical care are ineffective in reducing BMI are increasingly being considered for bariatric surgery, which encompasses a number of different surgical procedures (4)."
Reasoning: The introduction describes the rationale for the review in the context of rising childhood obesity prevalence and treatment guidelines.
[Yes]

P4. Introduction / Objectives
Quotes: "We aimed to (i) systematically review the literature on bariatric surgery in children and adolescents; (ii) meta-analyse change in BMI separately by surgery type and (iii) report complications, co-morbidity resolution and health-related quality of life (HRQoL)."
Reasoning: The objectives are explicitly stated with reference to participants, interventions, and outcomes.
[Yes]

P5. Methods / Protocol and registration
Quotes: None relevant.
Reasoning: No mention of a protocol or registration number.
[No]

P6. Methods / Eligibility criteria
Quotes: "Studies were included if (i) they assessed BMI before and a minimum of six months after individuals predominately received AGB, RYGB, BPD or SG and (ii) the mean age of the population was between 6 and 18 years at study entry (18)."
Reasoning: The eligibility criteria for study design, participants, interventions and outcomes are specified.
[Yes]

P7. Methods / Information sources
Quotes: "The indexed reference libraries EMBASE and Medline were searched between January 1955 and January 2013 using the search terms presented in Table 1, using mapped and exploded terms. Additionally, the references of all included studies, the Cochrane Library and the titles of papers published in the journal Obesity Surgery from January 1992 till January 2013 were searched."
Reasoning: The information sources searched are described with dates of coverage.
[Yes]

P8. Methods / Search
Quotes: "Search terms for EMBASE and Medline via Ovid SP 1. child/ or adolescent/ or paediatric/ 2. (child$ or young person$ or adolescent or paediatric).ab,ti. 3. bariatric surgery/ or gastric banding/ or stomach bypass/ or sleeve gastrectomy/ or biliopancreatic bypass/ 4. ('gastric bypass' or 'gastric banding' or 'sleeve gastrectomy' or 'biliopancreatic diversion').ab,ti. 5. (1 or 2) and (3 or 4)"
Reasoning: The full search strategy is provided for EMBASE and Medline.
[Yes]

P9. Methods / Study selection
Quotes: "A total of 2303 unique citations were returned by the search strategy (Fig. 1). Of these, 2185 were excluded based on abstract review. Two additional papers were retrieved during full text screening."
Reasoning: The process of screening and selecting studies is described.
[Yes]

P10. Methods / Data collection process
Quotes: None relevant.
Reasoning: The data collection process is not described in detail.
[No]

P11. Methods / Data items
Quotes: None relevant.
Reasoning: The variables for which data were sought are not explicitly defined.
[No]

P12. Methods / Risk of bias in individual studies
Quotes: None relevant.
Reasoning: The methods for assessing risk of bias are not described.
[No]

P13. Methods / Summary measures
Quotes: "Formulas outlined in the Cochrane Guidelines were used to derive necessary statistics or process individual data from each of the studies included in the meta-analysis (20). Median BMI estimates were not included in our review as variances are needed to meta-analyse data. The summary effect measure of unstandardized change in BMI at the time point closest to 12 months post-surgery was produced using the DerSimonian and Laird random effects method (21). The effect of heterogeneity was quantified using the I2 measure and a test of heterogeneity (22)."
Reasoning: The principal summary measures are described (unstandardized change in BMI).
[Yes]

P14. Methods / Synthesis of results
[NA] - Only one meta-analysis was performed.

P15. Methods / Risk of bias across studies
Quotes: None relevant.
Reasoning: Methods for assessing risk of bias across studies are not specified.
[No]

P16. Methods / Additional analyses
Quotes: "We also conducted a number of sensitivity analyses to examine whether change in BMI was effected by (i) the refinement of surgical techniques as publication date increased; (ii) gender and (iii) greater pre-surgery BMI. Funnel plots and Eggar's test were used to examine publication bias and small study effects."
Reasoning: Additional sensitivity analyses are described.
[Yes]

P17. Results / Study selection
Quotes: See Figure 1 flow diagram.
Reasoning: A flow diagram is provided showing the numbers of studies screened, assessed for eligibility, and included with reasons for exclusions at each stage.
[Yes]

P18. Results / Study characteristics
Quotes: See Table 2 with study characteristics.
Reasoning: For each included study, characteristics including sample size, age, BMI, and follow-up are provided along with citations.
[Yes]

P19. Results / Risk of bias within studies
[NA] - Risk of bias was not assessed.

P20. Results / Results of individual studies
Quotes: See Figure 2 forest plot.
Reasoning: For each study, the change in BMI with 95% confidence interval is presented in the forest plot.
[Yes]

P21. Results / Synthesis of results
[NA] - Only one meta-analysis was performed.

P22. Results / Risk of bias across studies
[NA] - Risk of bias across studies was not assessed.

P23. Results / Additional analysis
Quotes: "Surgical techniques differed among the RYGB group (Supporting Information Supplementary Digital Content 1). Only six studies gave details of the procedures completed beyond surgery type. Similarly, information on how measurements were taken, patient inclusion and exclusion criteria, and follow-up protocols were not consistently reported (Supporting Information Supplementary Digital Content 1)."
Reasoning: The results of the additional sensitivity analyses are reported.
[Yes]

P24. Discussion / Summary of evidence
Quotes: "Bariatric surgery in adolescents results in similar short-term weight outcomes to adults, with RYGB producing the greatest weight loss with the most robust evidence base. There are currently no other evidence-based medical interventions that result in similar magnitudes of weight loss, and this review suggests that bariatric surgery should be a treatment option, especially where there are weight-related complications."
Reasoning: The main findings are summarized including the strength of evidence and relevance to key groups.
[Yes]

P25. Discussion / Limitations
Quotes: "As bariatric surgery seems to be associated with a risk of complications and has the potential to impact on different patterns for a lifetime, a balance must be made between the potential benefits and harms at an individual case level. Surgery access is largely mediated through multidisciplinary teams (e.g. paediatricians, psychologists and dieticians) (42,43), and when applied in this context, bariatric surgery appears to be a viable choice to achieve weight loss in obese adolescents for whom all other interventions have failed. In the absence of higher levels of evidence, results from this systematic review appear to suggest that the potential benefits of surgery for weight loss outweigh the risks."
Reasoning: Limitations related to the evidence base and need for balancing risks and benefits are discussed.
[Yes]

P26. Discussion / Conclusions
Quotes: "As such, it is difficult to satisfy the condition of equipoise in an RCT when comparing an instantly reversible therapy (lifestyle or pharmacological intervention) with a surgical intervention that has a different risk profile and cost, and would be difficult to remedy or reverse."
Reasoning: The conclusions provide a general interpretation in the context of other evidence and implications for future research.
[Yes]

P27. Funding
Quotes: "No conflict of interest was declared."
Reasoning: Sources of funding for the systematic review are not described.
[No]

72. Borruto 2010: Laparoscopic vs open varicocelectomy in children and adolescents: review of the recent literature and meta-analysis

LLM response

16 quote(s) from publication full text (mean similarity 99.5%)

A1
Quote: "A literature search was performed, using Medline and Pubmed database, on all articles published during the last 10 years (2000-2009), reporting on varicocele treatments."
Reasoning: The authors specified the databases and years searched, indicating an a priori design.
[Yes]

A2
No relevant quotes found.
Reasoning: The authors did not mention duplicate study selection and data extraction.
[No]

A3
Quote: "Searches were also performed using the following key limits: last 10 years, adolescent, randomized controlled trials, meta-analysis, and multicenter retrospective and prospective studies."
Reasoning: The authors searched Medline and PubMed and used additional key limits, but did not mention supplementing with other sources like reviewing references or consulting experts.
[No]

A4
No relevant quotes found.
Reasoning: The authors did not specify whether they included grey literature.
[No]

A5
No relevant quotes found.
Reasoning: The authors did not provide a list of included and excluded studies.
[No]

A6
Quote: "The results of continuous variables were reported as mean ± SD, and the statistical difference was calculated using the Student's t test."
Reasoning: The authors reported some summary statistics of the included studies, but did not provide the full range of characteristics in aggregate form.
[No]

A7
Quote: "Articles with data regarding recurrence, complications (hydrocele, hematoma, atrophy), and, if available, semen parameters after treatment were analyzed."
Reasoning: The authors analyzed studies based on reported data on specific outcomes, but did not specify an a priori method for assessing study quality.
[No]

A8
No relevant quotes found.
Reasoning: Since the authors did not assess study quality, they could not have used it appropriately in the conclusions.
[NA]

A9
Quotes: "To our knowledge, there is no meta-analysis that compares the various techniques for varicocele treatment in children. The only one found in literature concerns adult patients [9]." "Meta-analysis is a useful statistical tool that can be used to compare and integrate different studies in both a qualitative and quantitative way, considering variations in characteristics that can influence the overall estimate of the outcome of interest."
Reasoning: The authors acknowledge the usefulness of meta-analysis for comparing studies, but one was not performed in this review.
[NA]

A10
No relevant quotes found.
Reasoning: The authors did not assess the likelihood of publication bias.
[NA]

A11
No relevant quotes found.
Reasoning: The authors did not report the sources of support for the included studies or for this systematic review.
[No]

P1
Quote: "Laparoscopic vs open varicocelectomy in children and adolescents: review of the recent literature and meta-analysis"
Reasoning: The title identifies the article as a review and meta-analysis.
[Yes]

P2
Quote: "Purpose: Laparoscopic varicocelectomy has gained popularity in recent years. The aim of this study was to identify clinical evidence about the reliability of this technique in the recent literature. Methods: We performed a Medline search for articles published during the last 10 years, using the key words "varicocele," "treatment," and "adolescent." As limits, we used last 10 years, adolescent, clinical trials, randomized controlled trials, meta-analysis, and multicenter retrospective and prospective studies. The results were investigated in recurrence and hydrocele formation."
Reasoning: The abstract includes structured sections with background, objectives, methods, and results.
[Yes]

P3
Quote: "Varicocele is generally considered the most common correctable cause of male infertility [1,2]. It is indicated as a factor in about one third of infertile males, being associated with testicular atrophy and abnormal seminal factors [3]."
Reasoning: The introduction describes the rationale for the review in the context of what is known about varicocele and male infertility.
[Yes]

P4
No relevant quotes found.
Reasoning: The authors did not explicitly state the PICOS for the review question.
[No]

P5
No relevant quotes found.
Reasoning: The authors did not mention the existence of or access to a review protocol.
[No]

P6
Quote: "(1) studies that were not relevant, in which outcome of interest were not reported or were impossible to calculate from the results; and (2) studies not concerning an adolescent population."
Reasoning: The authors specified the study characteristics used as eligibility criteria.
[Yes]

P7
Quote: "A literature search was performed, using Medline and Pubmed database, on all articles published during the last 10 years (2000-2009), reporting on varicocele treatments."
Reasoning: The authors described the databases searched and years covered, but did not specify the date last searched.
[No]

P8
No relevant quotes found.
Reasoning: The authors did not present the full search strategy for any database.
[No]

P9
Quote: "Eleven studies published between 2000 and 2009 matched the inclusion criteria, comparing varicocele treatments in the adolescent population and reporting the incidence of complications."
Reasoning: The authors stated the number of studies included after applying eligibility criteria, but did not fully describe the study selection process.
[No]

P10
Quote: "The results of continuous variables were reported as mean ± SD, and the statistical difference was calculated using the Student's t test."
Reasoning: The authors mentioned how some data were reported and analyzed, but did not fully describe the data collection process.
[No]

P11
Quote: "Articles with data regarding recurrence, complications (hydrocele, hematoma, atrophy), and, if available, semen parameters after treatment were analyzed."
Reasoning: The authors listed the main variables for which data were sought from the studies.
[Yes]

P12
No relevant quotes found.
Reasoning: The authors did not describe methods for assessing risk of bias in the included studies.
[No]

P13
No relevant quotes found.
Reasoning: The authors did not state the principal summary measures.
[No]

P14
No relevant quotes found.
Reasoning: The authors did not perform a meta-analysis.
[NA]

P15
No relevant quotes found.
Reasoning: The authors did not perform a meta-analysis.
[NA]

P16
No relevant quotes found.
Reasoning: The authors did not perform a meta-analysis.
[NA]

P17
No relevant quotes found.
Reasoning: The authors did not provide a flow diagram or full details on the number of studies screened and excluded at each stage.
[No]

P18
No relevant quotes found.
Reasoning: The authors did not present the characteristics and citations of each included study.
[No]

P19
No relevant quotes found.
Reasoning: The authors did not provide data on the risk of bias of each included study.
[No]

P20
Quotes: See Figures 1-4 which present forest plots with odds ratios and 95% confidence intervals for each included study.
Reasoning: The authors provided effect estimates and confidence intervals for the individual studies in forest plots.
[Yes]

P21
No relevant quotes found.
Reasoning: The authors did not perform a meta-analysis.
[NA]

P22
No relevant quotes found.
Reasoning: The authors did not perform a meta-analysis.
[NA]

P23
No relevant quotes found.
Reasoning: The authors did not perform a meta-analysis.
[NA]

P24
Quote: "Varicocele has an adverse effect on the histologic, endocrine, and biochemical testis function [11]. To date, there is controversy over the management of varicocele in children and adolescents. The variety of treatment options indicates that the ideal technique to manage this pathologic condition is not yet been determined."
Reasoning: The authors summarized the main findings and their relevance to key stakeholders.
[Yes]

P25
No relevant quotes found.
Reasoning: The authors did not discuss the limitations of the review at the study, outcome, and review level.
[No]

P26
Quote: "Varicocele has an adverse effect on the histologic, endocrine, and biochemical testis function [11]. To date, there is controversy over the management of varicocele in children and adolescents. The variety of treatment options indicates that the ideal technique to manage this pathologic condition is not yet been determined."
Reasoning: The authors provided a general interpretation of the results in the context of other evidence and the need for determining the ideal treatment technique.
[Yes]

P27
No relevant quotes found.
Reasoning: The authors did not describe the sources of funding or other support for conducting the systematic review.
[No]

73. Castagnetti 2010: Surgical Management of Primary Severe Hypospadias in Children: Systematic 20-Year Review

LLM response

14 quote(s) from publication full text (mean similarity 98.6%)

A1
Quote: "We systematically reviewed the literature published during the last 20 years on the treatment of primary proximal hypospadias associated with severe ventral curvature."
Reasoning: The research question and inclusion criteria are clearly stated.
[Yes]

A2
Quotes: No relevant quotes identified.
Reasoning: The authors do not mention whether study selection and data extraction were performed in duplicate.
[No]

A3
Quotes: "We reviewed studies published between 1990 and December 2009, searching for "hypospadias" in MEDLINE®/PubMed®, EMBASE®, Web of Science® and the Cochrane Library."
Reasoning: At least 2 electronic databases were searched and the search term is provided.
[Yes]

A4
Quotes: No relevant quotes identified.
Reasoning: The authors do not state whether they searched for reports regardless of publication type.
[No]

A5
Quotes: No relevant quotes identified.
Reasoning: A list of included and excluded studies is not provided.
[No]

A6
Quote: "We identified 69 studies for review. These studies were generally of low quality (69.5% surgical series)."
Reasoning: Aggregate data on study characteristics are not provided.
[No]

A7
Quote: "We identified 69 studies for review. These studies were generally of low quality (69.5% surgical series)."
Reasoning: The authors assessed study quality in a limited way.
[No]

A8
Quotes: No relevant quotes identified.
Reasoning: The authors do not appear to have used study quality in formulating conclusions.
[No]

A9
Quotes: Not applicable, as no meta-analysis was performed.
Reasoning: The systematic review did not include a meta-analysis.
[NA]

A10
Quotes: Not applicable, as no meta-analysis was performed.
Reasoning: The systematic review did not include a meta-analysis.
[NA]

A11
Quotes: No relevant quotes identified.
Reasoning: Potential sources of support are not acknowledged for the systematic review or included studies.
[No]

P1
Quote: "Surgical Management of Primary Severe Hypospadias in Children: Systematic 20-Year Review"
Reasoning: The title identifies the article as a systematic review.
[Yes]

P2
Quote: The abstract is structured with labeled sections for Purpose, Materials and Methods, Results, and Conclusions.
Reasoning: A structured abstract is provided.
[Yes]

P3
Quote: "The ideal surgical management of primary severe hypospadias (proximal hypospadias with severe ventral curvature) remains controversial."
Reasoning: The rationale for the review is described in the context of what is known.
[Yes]

P4
Quote: "We systematically reviewed the literature published during the last 20 years on the treatment of primary proximal hypospadias associated with severe ventral curvature."
Reasoning: The research question specifies the population, intervention and study design.
[Yes]

P5
Quotes: No relevant quotes identified.
Reasoning: The existence of a review protocol is not mentioned.
[No]

P6
Quote: "We systematically reviewed the literature published during the last 20 years on the treatment of primary proximal hypospadias associated with severe ventral curvature."
Reasoning: The inclusion criteria for study characteristics and report characteristics are described.
[Yes]

P7
Quote: "We reviewed studies published between 1990 and December 2009, searching for "hypospadias" in MEDLINE®/PubMed®, EMBASE®, Web of Science® and the Cochrane Library."
Reasoning: The information sources and dates of coverage are described.
[Yes]

P8
Quotes: No relevant quotes identified.
Reasoning: The full search strategy is not presented.
[No]

P9
Quote: "Selected publications and congress abstracts were studied."
Reasoning: The study selection process is briefly mentioned but not described in detail.
[No]

P10
Quotes: No relevant quotes identified.
Reasoning: The data collection process is not described.
[No]

P11
Quotes: No relevant quotes identified.
Reasoning: The data items collected are not listed or defined.
[No]

P12
Quotes: No relevant quotes identified.
Reasoning: The methods for assessing risk of bias of individual studies are not described.
[No]

P13
Quotes: Not applicable, as no meta-analysis was performed.
Reasoning: The systematic review did not include a meta-analysis.
[NA]

P14
Quotes: Not applicable, as no meta-analysis was performed.
Reasoning: The systematic review did not include a meta-analysis.
[NA]

P15
Quotes: Not applicable, as no meta-analysis was performed.
Reasoning: The systematic review did not include a meta-analysis.
[NA]

P16
Quotes: Not applicable, as no meta-analysis was performed.
Reasoning: The systematic review did not include a meta-analysis.
[NA]

P17
Quote: "The search yielded 69 pertinent studies."
Reasoning: The number of included studies is provided, but a flow diagram is not included and reasons for exclusions are not given.
[No]

P18
Quotes: No relevant quotes identified.
Reasoning: Characteristics of individual studies are not presented.
[No]

P19
Quotes: No relevant quotes identified.
Reasoning: Results of the risk of bias assessment are not presented.
[No]

P20
Quotes: No relevant quotes identified.
Reasoning: Results for individual studies are not provided.
[No]

P21
Quotes: Not applicable, as no meta-analysis was performed.
Reasoning: The systematic review did not include a meta-analysis.
[NA]

P22
Quotes: Not applicable, as no meta-analysis was performed.
Reasoning: The systematic review did not include a meta-analysis.
[NA]

P23
Quotes: Not applicable, as no meta-analysis was performed.
Reasoning: The systematic review did not include a meta-analysis.
[NA]

P24
Quote: "The present systematic review shows the weak evidence backing current management of primary severe hypospadias. We even lack a clear-cut definition of severe hypospadias and associated curvature."
Reasoning: The main findings are summarized.
[Yes]

P25
Quote: "As we continually try to improve the outcomes for our patients with hypospadias, we need to have a better classification system. As the authors indicate, "Future research should strive to stratify included cases accurately based on meatal position and curvature preoperatively, following skin degloving and following each step required for straightening.""
Reasoning: Limitations at the review level are discussed.
[Yes]

P26
Quote: "Clearly it is our obligation to work together with severe hypospadias pediatric urology community so that better outcomes studies can be performed for our patients, ultimately improving their well-being."
Reasoning: A general interpretation is provided in the context of other evidence and implications for future research are discussed.
[Yes]

P27
Quotes: No relevant quotes identified.
Reasoning: Sources of funding for the systematic review are not described.
[No]

74. Castagnetti 2016: Does Preputial Reconstruction Increase Complication Rate of Hypospadias Repair? 20-Year Systematic Review and Meta-Analysis

LLM response

22 quote(s) from publication full text (mean similarity 99.9%)

A1 - Was an 'a priori' design provided?
Quotes: "We performed a systematic review of the literature on preputial reconstruction (PR) during hypospadias repair to determine the cumulative risk of preputial skin complications and the influence of PR on urethroplasty complications, namely, fistula formation and overall reoperation rate of the repair."
Reasoning: The research question and inclusion criteria were established before conducting the review.
[Yes]

A2 - Was there duplicate study selection and data extraction?
Quotes: "A second review was performed of these papers and their reference lists."
Reasoning: A second review was performed, but it is unclear if there were at least two independent data extractors and a consensus procedure.
[No]

A3 - Was a comprehensive literature search performed?
Quotes: "A systematic search of the literature published after 06/1995 was performed in 06/2015 using the keyword "hypospadias." Only studies on the outcome of PR in children, defined as dehiscence of the reconstructed prepuce or secondary phimosis needing circumcision, were selected."
Reasoning: At least two databases (MEDLINE/PubMed, Scopus, and Cochrane library) were searched with the keyword "hypospadias".
[Yes]

A4 - Was the status of publication (i.e. grey literature) used as an inclusion criterion?
Quotes: No relevant quotes found.
Reasoning: The authors did not state that they searched for reports regardless of publication type or whether they excluded any reports based on publication status.
[No]

A5 - Was a list of studies (included and excluded) provided?
Quotes: "One-thousand two-hundred thirty records were retrieved by searching MEDLINE/PubMed, 2461 Web of Sciences, and 1 the Cochrane library. Three doctors reviewed separately the abstracts. Papers relevant to the topic of the review were selected by consensus."
Reasoning: The number of included and excluded studies at each stage was provided, but not an actual list of the studies.
[No]

A6 - Were the characteristics of the included studies provided?
Quotes: Table 1 provides characteristics of the included studies such as author, country of origin, type of study, patients undergoing PR/hypospadias repairs, hypospadias severity, and hypospadias repair.
Reasoning: The characteristics of the included studies were provided in an aggregated form in Table 1.
[Yes]

A7 - Was the scientific quality of the included studies assessed and documented?
Quotes: No relevant quotes found.
Reasoning: The authors did not provide any 'a priori' methods for assessing study quality or report the results of a quality assessment.
[No]

A8 - Was the scientific quality of the included studies used appropriately in formulating conclusions?
[NA] - Quality assessment was not performed (A7), so this item is not applicable.

A9 - Were the methods used to combine the findings of studies appropriate?
Quotes: "A meta-analysis (Figure 2) showed no increased risk of urethral fistula formation in patients where the prepuce was preserved, OR (Mantel–Haenszel, fixed effect, 95% CI), 1.25 (0.80–1.97). This was even more evident after exclusion of retrospective studies, i.e., considering only studies with higher LOE (Figure 2)."
Reasoning: A meta-analysis was performed and heterogeneity was assessed using the I2 statistic. Fixed-effects models were used.
[Yes]

A10 - Was the likelihood of publication bias assessed?
Quotes: "Funnel Plot did not show evidence of significant bias among studies (Figure 3)."
Reasoning: Publication bias was assessed using a funnel plot.
[Yes]

A11 - Was the conflict of interest included?
Quotes: No relevant quotes found.
Reasoning: The authors did not acknowledge sources of support or conflict of interest for the systematic review or the included studies.
[No]

P1 - Title
Quotes: "Does Preputial Reconstruction Increase Complication Rate of Hypospadias Repair? 20-Year Systematic Review and Meta-Analysis"
Reasoning: The title identifies the article as a systematic review and meta-analysis.
[Yes]

P2 - Abstract / Structured summary
Quotes: The abstract includes labeled sections for Introduction, Materials and Methods, Results, and Conclusion.
Reasoning: The abstract is structured with distinct labeled sections covering the main PRISMA elements.
[Yes]

P3 - Introduction / Rationale
Quotes: "Preputial asymmetry is one of the components of hypospadias. The prepuce stands like a hood over the glans penis, open ventrally, and redundant dorsally. Preputial reconstruction (PR) is an option during hypospadias repair, but many surgeons favor circumcision for the concern that PR might increase the complication rate of hypospadias repair (1)."
Reasoning: The rationale for the review is described in the context of what is known about preputial reconstruction in hypospadias repair.
[Yes]

P4 - Introduction / Objectives
Quotes: "We performed a systematic review of the literature on preputial reconstruction (PR) during hypospadias repair to determine the cumulative risk of preputial skin complications and the influence of PR on urethroplasty complications, namely, fistula formation and overall reoperation rate of the repair."
Reasoning: The objectives are explicitly stated with reference to participants, interventions, and outcomes.
[Yes]

P5 - Methods / Protocol and registration
Quotes: No relevant quotes found.
Reasoning: The authors did not indicate if a review protocol exists or provide registration information.
[No]

P6 - Methods / Eligibility criteria
Quotes: "Only studies on the outcome of PR in children, defined as dehiscence of the reconstructed prepuce or secondary phimosis needing circumcision, were selected."
Reasoning: The study characteristics used as criteria for eligibility were specified.
[Yes]

P7 - Methods / Information sources
Quotes: "A systematic search of the literature published after 06/1995 was performed in 06/2015 using the keyword "hypospadias." Only studies on the outcome of PR in children, defined as dehiscence of the reconstructed prepuce or secondary phimosis needing circumcision, were selected."
Reasoning: The information sources (literature published after 06/1995) and the date last searched (06/2015) were described.
[Yes]

P8 - Methods / Search
Quotes: No relevant quotes found.
Reasoning: The full electronic search strategy was not presented such that it could be repeated.
[No]

P9 - Methods / Study selection
Quotes: "One-thousand two-hundred thirty records were retrieved by searching MEDLINE/PubMed, 2461 Web of Sciences, and 1 the Cochrane library. Three doctors reviewed separately the abstracts. Papers relevant to the topic of the review were selected by consensus."
Reasoning: The process for selecting studies, including screening and eligibility, was stated.
[Yes]

P10 - Methods / Data collection process
Quotes: No relevant quotes found.
Reasoning: The method of data extraction was not described.
[No]

P11 - Methods / Data items
Quotes: No relevant quotes found.
Reasoning: The authors did not provide a list of variables for which data were sought.
[No]

P12 - Methods / Risk of bias in individual studies
Quotes: No relevant quotes found.
Reasoning: The methods for assessing risk of bias in individual studies were not described.
[No]

P13 - Methods / Summary measures
Quotes: "A meta-analysis (Figure 2) showed no increased risk of urethral fistula formation in patients where the prepuce was preserved, OR (Mantel–Haenszel, fixed effect, 95% CI), 1.25 (0.80–1.97)."
Reasoning: Odds ratio was used as the summary measure in the meta-analysis.
[Yes]

P14 - Methods / Synthesis of results
Quotes: "A meta-analysis (Figure 2) showed no increased risk of urethral fistula formation in patients where the prepuce was preserved, OR (Mantel–Haenszel, fixed effect, 95% CI), 1.25 (0.80–1.97). This was even more evident after exclusion of retrospective studies, i.e., considering only studies with higher LOE (Figure 2)."
Reasoning: The methods for the meta-analysis were described, including the use of fixed-effect models and measures of consistency (I2).
[Yes]

P15 - Methods / Risk of bias across studies
Quotes: "Funnel Plot did not show evidence of significant bias among studies (Figure 3)."
Reasoning: Assessment of risk of bias across studies (publication bias) using a funnel plot was specified.
[Yes]

P16 - Methods / Additional analyses
Quotes: "A meta-analysis (Figure 2) showed no increased risk of urethral fistula formation in patients where the prepuce was preserved, OR (Mantel–Haenszel, fixed effect, 95% CI), 1.25 (0.80–1.97). This was even more evident after exclusion of retrospective studies, i.e., considering only studies with higher LOE (Figure 2)."
Reasoning: Additional analysis excluding retrospective studies was described.
[Yes]

P17 - Results / Study selection
Quotes: Figure 1 provides a flowchart showing the process for selection of studies, with the number of studies at each stage.
Reasoning: The number of studies screened, assessed for eligibility, and included in the review were provided with a flow diagram.
[Yes]

P18 - Results / Study characteristics
Quotes: Table 1 presents the characteristics of each included study.
Reasoning: The characteristics of the included studies were presented with citations.
[Yes]

P19 - Results / Risk of bias within studies
[NA] - Risk of bias assessment was not performed (P12).

P20 - Results / Results of individual studies
Quotes: Table 2 presents the complication rates and reoperation rates for each included study.
Reasoning: For each study, summary data for the intervention groups were provided.
[Yes]

P21 - Results / Synthesis of results
Quotes: "A meta-analysis (Figure 2) showed no increased risk of urethral fistula formation in patients where the prepuce was preserved, OR (Mantel–Haenszel, fixed effect, 95% CI), 1.25 (0.80–1.97). This was even more evident after exclusion of retrospective studies, i.e., considering only studies with higher LOE (Figure 2)."
Reasoning: The results of the meta-analysis were presented, including confidence intervals and measures of consistency.
[Yes]

P22 - Results / Risk of bias across studies
Quotes: "Funnel Plot did not show evidence of significant bias among studies (Figure 3)."
Reasoning: The results of the assessment of risk of bias across studies (publication bias) using a funnel plot were presented.
[Yes]

P23 - Results / Additional analysis
Quotes: "This was even more evident after exclusion of retrospective studies, i.e., considering only studies with higher LOE (Figure 2)."
Reasoning: The results of the additional analysis excluding retrospective studies were provided.
[Yes]

P24 - Discussion / Summary of evidence
Quotes: "This systematic review shows that according to available evidence PR carries an 8% risk of specific preputial complications, whereas it does not seem to increase the risk of urethroplasty complications and the overall reoperation rate of hypospadias repairs."
Reasoning: The main findings were summarized, including the strength of evidence for the main outcomes.
[Yes]

P25 - Discussion / Limitations
Quotes: "Regarding the role of steroid ointment application compared to spontaneous improvement and simple manipulation. Unfortunately, the vast majority of available studies has limited follow-up (below 2 years) to determine the final outcome of PR and none reported results in post-pubertal patients."
Reasoning: Some limitations at the study and review level were discussed.
[Yes]

P26 - Discussion / Conclusions
Quotes: "Preputial reconstruction is an option particularly in patients with distal hypospadias without associated penile curvature. It carries an 8% risk of specific complications, the most common being dehiscence of reconstructed prepuce, whereas secondary phimosis needing circumcision seems to be exceptional although we lack long-term follow-up data on these patients."
Reasoning: A general interpretation of the results in the context of other evidence was provided.
[Yes]

P27 - Funding
Quotes: No relevant quotes found.
Reasoning: The sources of funding for the systematic review were not described.
[No]

75. Chan 2014 (Pediatr Surg Int): Ideal timing of orchiopexy: a systematic review

LLM response

17 quote(s) from publication full text (mean similarity 97%)

A1. Was an 'a priori' design provided?
Quotes: None relevant.
Reasoning: The authors do not mention a protocol, ethics approval, or pre-determined objectives.
[No]

A2. Was there duplicate study selection and data extraction?
Quotes: "Two researchers independently performed each level of screening, comparing the scores for each item on each tool to reach a consensus. If no consensus could be reached, they consulted a third researcher."
Reasoning: Two researchers independently screened studies and compared results to reach consensus.
[Yes]

A3. Was a comprehensive literature search performed?
Quotes: "We conducted electronic searches of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (1966 onwards), Embase (1980 onwards), and CINAHL (1982 onwards) to find relevant articles. We used the following search terms: "Cryptorchidism" AND "Orchidopexy" AND "timing" OR "age"."
Reasoning: At least 2 electronic databases were searched along with relevant search terms.
[Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
Quotes: None relevant.
Reasoning: The authors do not mention searching for grey literature or including unpublished studies.
[No]

A5. Was a list of studies (included and excluded) provided?
Quotes: None relevant.
Reasoning: The authors do not provide a list of included and excluded studies.
[No]

A6. Were the characteristics of the included studies provided?
Quotes: "From there, we were able to reach a conclusion regarding the ideal timing of orchiopexy in cryptorchid children, based on the highest quality research available."
Reasoning: The authors mention reaching a conclusion based on the highest quality research but do not provide the characteristics of the included studies in an aggregated form.
[No]

A7. Was the scientific quality of the included studies assessed and documented?
Quotes: "We used the AMSTAR [20] tool to assess the quality of all relevant systematic reviews. This tool contains 11 items, for a maximum score of 11. Higher scores are indicative of greater methodological quality. This version of the AMSTAR tool includes additional notes to help clarify the items, which were established through conversations with the tool's creator by the Cochrane Effective Practice and Organization of Care review group."
Reasoning: The authors used the AMSTAR tool to assess the methodological quality of the included systematic reviews.
[Yes]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
Quotes: "From there, we were able to reach a conclusion regarding the ideal timing of orchiopexy in cryptorchid children, based on the highest quality research available."
Reasoning: The authors state they based their conclusions on the highest quality evidence available.
[Yes]

A9. Were the methods used to combine the findings of studies appropriate?
Quotes: None relevant.
Reasoning: The authors did not perform a meta-analysis or quantitatively combine study findings.
[NA]

A10. Was the likelihood of publication bias assessed?
Quotes: None relevant. 
Reasoning: The authors did not assess publication bias.
[NA]

A11. Was the conflict of interest included?
Quotes: None relevant.
Reasoning: The authors do not report the sources of funding or conflicts of interest for the included studies.
[No]

P1. Title: Identify the report as a systematic review, meta-analysis, or both.
Quote: "Ideal timing of orchiopexy: a systematic review"
Reasoning: The title identifies the article as a systematic review.
[Yes]

P2. Abstract / Structured summary
Quotes: The abstract contains labeled sections for Background, Methods, Results, and Conclusion.
Reasoning: The abstract is structured with distinct labeled sections covering the main PRISMA elements.
[Yes]

P3. Introduction / Rationale
Quote: "Cryptorchidism, the failure of one or both testes to descend into the scrotum prenatally, occurs in 2.4–5 % of newborns [1, 2]. Many of these testes will descend spontaneously shortly after birth, but approximately 23 % will remain undescended unless surgery is performed [3]."
Reasoning: The introduction describes the rationale for the review in the context of what is known about cryptorchidism.
[Yes]

P4. Introduction / Objectives
Quote: "To address this problem, we conducted a systematic review, focusing on fertility and testicular malignancy outcomes, and assessing the quality of each study."
Reasoning: The objectives are stated, mentioning the focus on fertility and malignancy outcomes and quality assessment.
[Yes]

P5. Methods / Protocol and registration
Quotes: None relevant.
Reasoning: The authors do not mention a protocol or registration number.
[No]

P6. Methods / Eligibility criteria
Quote: "We identified all studies that examined the effect of age at orchiopexy on fertility or malignancy, even if these outcomes were not the primary focus. If we deemed a study relevant based on the title and abstract, we obtained the full text article to further screen for relevance."
Reasoning: The eligibility criteria for studies are described.
[Yes]

P7. Methods / Information sources
Quote: "We conducted electronic searches of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (1966 onwards), Embase (1980 onwards), and CINAHL (1982 onwards) to find relevant articles."
Reasoning: The electronic databases searched are listed.
[Yes]

P8. Methods / Search
Quote: "We used the following search terms: "Cryptorchidism" AND "Orchidopexy" AND "timing" OR "age"."
Reasoning: The search terms are provided but the full search strategy for at least one database is not presented.
[No]

P9. Methods / Study selection
Quote: "Two researchers independently performed each level of screening, comparing the scores for each item on each tool to reach a consensus. If no consensus could be reached, they consulted a third researcher."
Reasoning: The process for study selection is described.
[Yes]

P10. Methods / Data collection process
Quote: "One researcher extracted data from each of the included studies, and a second researcher checked the data for accuracy and completeness."
Reasoning: The data extraction process is described.
[Yes]

P11. Methods / Data items
Quotes: None relevant.
Reasoning: The authors do not specify all the data items sought.
[No]

P12. Methods / Risk of bias in individual studies
Quotes: "We used the Jadad et al. [21] tool to assess the quality of all relevant RCTs. This scale contains seven items, two of which are reverse-scored. The maximum score is 5, with higher scores indicating greater methodological quality."
"We used the MINORS criteria [22] to assess the quality of all relevant non-randomized studies. This tool contains 12 items, each of which can be scored from 0 to 2, for a maximum possible score of 24 (comparison studies) or 16 (non-comparison studies). Higher scores are indicative of greater methodological quality."
Reasoning: The authors describe using the Jadad and MINORS tools to assess risk of bias in RCTs and non-randomized studies respectively.
[Yes]

P13. Methods / Summary measures
Quotes: None relevant.
Reasoning: The authors do not state the principal summary measures as no quantitative synthesis was performed.
[NA]

P14. Methods / Synthesis of results
Quotes: None relevant.
Reasoning: No quantitative synthesis was performed.
[NA]

P15. Methods / Risk of bias across studies
Quotes: None relevant.
Reasoning: The authors did not assess risk of bias that may affect the cumulative evidence.
[No]

P16. Methods / Additional analyses
Quotes: None relevant.
Reasoning: No additional analyses were reported.
[NA]

P17. Results / Study selection
Quote: See Figure 1 flow diagram.
Reasoning: A flow diagram is provided showing the number of studies at each stage of the selection process.
[Yes]

P18. Results / Study characteristics
Quotes: See Tables 1 and 2 with study characteristics.
Reasoning: The key characteristics of the included studies are provided in table format.
[Yes]

P19. Results / Risk of bias within studies
Quotes: None relevant.
Reasoning: The authors do not present the risk of bias assessments for each included study.
[No]

P20. Results / Results of individual studies
Quotes: See Tables 1 and 2 with study results.
Reasoning: For each study, summary data and effect estimates are provided in the tables.
[Yes]

P21. Results / Synthesis of results
Quotes: None relevant.
Reasoning: No meta-analysis was performed.
[NA]

P22. Results / Risk of bias across studies
Quotes: None relevant.
Reasoning: Risk of bias across studies was not assessed.
[NA]

P23. Results / Additional analysis
Quotes: None relevant.
Reasoning: No additional analyses were reported.
[NA]

P24. Discussion / Summary of evidence
Quote: "The ideal timing of orchiopexy for cryptorchidism has long been debated. Although the recommended age for this surgery has decreased over the years, the literature is still unclear about the exact age at which orchiopexy should be performed to optimize patient outcomes."
Reasoning: The authors summarize the main findings regarding the ideal timing of orchiopexy.
[Yes]

P25. Discussion / Limitations
Quote: "As with all non-RCTs, there are many potential sources of bias. For example, non-RCTs often have ambiguous exclusion criteria for the participants, and the study design does not often involve blinding. In addition, there is risk of selection bias, where the study groups are not equivalent on variables other than the outcome in question."
Reasoning: Limitations of the non-randomized studies are discussed.
[Yes]

P26. Discussion / Conclusions
Quote: "Thus, we recommend that orchiopexy be performed after 6 months of age, to allow for possible natural descent. If the testis remains cryptorchid after 6 months, orchiopexy should be performed as soon as possible—and certainly before 1 year of age—to optimize fertility outcomes."
Reasoning: The authors provide conclusions based on their review.
[Yes]

P27. Funding
Quotes: None relevant.
Reasoning: Sources of funding for the systematic review are not reported.
[No]

76. Chan 2014 (J Pediatr Surg): Minimally invasive versus open repair of Bochdalek hernia: a meta-analysis

LLM response

24 quote(s) from publication full text (mean similarity 98.6%)

A1. Was an 'a priori' design provided?
Quote: "Our objective was to compare the outcomes of these procedures in a systematic review and meta-analysis."
Reasoning: The objective was stated, but no mention of a protocol or pre-registered design.
[No]

A2. Was there duplicate study selection and data extraction?
Quote: "Two researchers independently assessed each study and compared their scores for each item to reach a consensus. If an agreement could not be reached, they consulted a third researcher."
Reasoning: Study selection and quality assessment was done in duplicate.
[Yes]

A3. Was a comprehensive literature search performed?
Quotes: "To identify all studies comparing MIS with open surgery for CDH repair, we conducted an electronic search of MEDLINE (1966 onwards), Embase (1980 onwards), and the Cochrane Central Register of Controlled Trials (CENTRAL)." "All searches were supplemented by searching, thus we included 10 studies in total [8–17]."
Reasoning: At least 2 databases plus reference searching was performed.
[Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
Reasoning: No mention of including grey literature or unpublished studies.
[No]

A5. Was a list of studies (included and excluded) provided?
Quote: "Our initial search of MEDLINE, Embase and CENTRAL yielded 160 studies (Fig. 1). After applying our exclusion criteria, 9 studies remained. We identified one additional relevant study through hand-searching, thus we included 10 studies in total [8–17]."
Reasoning: A flow diagram of included and excluded studies was provided.
[Yes]

A6. Were the characteristics of the included studies provided?
Quote: "We did not identify any randomized controlled trials (RCTs) as all identified studies were retrospective in nature. Characteristics of studies included in the meta-analysis are detailed in Table 1."
Reasoning: Study characteristics were provided in an aggregated table.
[Yes]

A7. Was the scientific quality of the included studies assessed and documented?
Quote: "Two researchers independently assessed each study for methodological quality using MINORS. The score for each study is reported in Table 1."
Reasoning: Study quality was assessed using the MINORS tool and scores reported for each study.
[Yes]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
Reasoning: The quality of studies was not explicitly considered when formulating conclusions.
[No]

A9. Were the methods used to combine the findings of studies appropriate?
Quotes: "We conducted our meta-analyses using Review Manager 5.2 [6]. For each outcome, we first assessed the heterogeneity of the studies (Chi2 test and I2 statistic). When heterogeneity was low to moderate (Q test p > 0.10, I2 < 50%), we used a fixed-effects model. When heterogeneity was moderate to high (Q test p < 0.10, I2 > 50%), we used a random-effects model [7]."
Reasoning: Appropriate methods were used to assess heterogeneity and combine studies based on heterogeneity.
[Yes]

A10. Was the likelihood of publication bias assessed?
Quote: "To address the risk of publication bias, we created a funnel plot for the recurrence outcome (Fig. 2). All of the studies fell within the 95% confidence interval lines, although the plot was slightly asymmetrical, indicating the possibility of publication bias."
Reasoning: Publication bias was assessed using a funnel plot.
[Yes]

A11. Was the conflict of interest included?
Reasoning: The source of funding for the systematic review was not stated, and conflicts of interest for the included studies were not reported.
[No]

P1. Title
Quote: "Minimally invasive versus open repair of Bochdalek hernia: a meta-analysis"
Reasoning: The title identifies the article as a meta-analysis.
[Yes]

P2. Abstract / Structured summary
Reasoning: The abstract has labeled sections covering background, methods, results, and conclusions.
[Yes]

P3. Introduction / Rationale
Quote: "Traditionally, CDH repair was performed using an open approach, most often by laparotomy. In 1995, Silen performed the first MIS repair on an adolescent patient, and since then the minimally invasive technique has undergone significant evolution [3], becoming increasingly employed over the last 10 years."
Reasoning: The rationale for the review is provided in the context of what is known.
[Yes]

P4. Introduction / Objectives
Quote: "Our objective was to compare the outcomes of these procedures in a systematic review and meta-analysis."
Reasoning: The objective is explicitly stated, although PICOS elements are not fully specified.
[Yes]

P5. Methods / Protocol and registration
Reasoning: No mention of a protocol or registration number.
[No]

P6. Methods / Eligibility criteria
Quote: "Characteristics of studies included in the meta-analysis are detailed in Table 1."
Reasoning: Study characteristics used as eligibility criteria are reported.
[Yes]

P7. Methods / Information sources
Quote: "To identify all studies comparing MIS with open surgery for CDH repair, we conducted an electronic search of MEDLINE (1966 onwards), Embase (1980 onwards), and the Cochrane Central Register of Controlled Trials (CENTRAL). We used the keywords "diaphragmatic hernia", "thoracoscopy", "laparoscopy", "minimally invasive surgery", and "open". We excluded any studies that did not pertain to humans and children."
Reasoning: Electronic databases searched are described with dates of coverage.
[Yes]

P8. Methods / Search
Quote: "We used the keywords "diaphragmatic hernia", "thoracoscopy", "laparoscopy", "minimally invasive surgery", and "open"."
Reasoning: Search terms are provided but the full search strategy for each database is not presented.
[No]

P9. Methods / Study selection
Quote: "Our initial search of MEDLINE, Embase and CENTRAL yielded 160 studies (Fig. 1). After applying our exclusion criteria, 9 studies remained. We identified one additional relevant study through hand-searching, thus we included 10 studies in total [8–17]."
Reasoning: The study selection process is described and shown in a flow diagram.
[Yes]

P10. Methods / Data collection process
Reasoning: The data extraction process is not described.
[No]

P11. Methods / Data items
Reasoning: Variables for which data were sought are not defined.
[No]

P12. Methods / Risk of bias in individual studies
Quote: "Two researchers independently assessed each study for methodological quality using MINORS. The score for each study is reported in Table 1. All studies were retrospective in nature and none employed a blinding technique for data collection."
Reasoning: The MINORS tool was used to assess risk of bias in individual studies.
[Yes]

P13. Methods / Summary measures
Reasoning: The principal summary measures are not stated.
[No]

P14. Methods / Synthesis of results
Quote: "We conducted our meta-analyses using Review Manager 5.2 [6]. For each outcome, we first assessed the heterogeneity of the studies (Chi2 test and I2 statistic). When heterogeneity was low to moderate (Q test p > 0.10, I2 < 50%), we used a fixed-effects model. When heterogeneity was moderate to high (Q test p < 0.10, I2 > 50%), we used a random-effects model [7]."
Reasoning: Methods for data synthesis and assessing consistency are described.
[Yes]

P15. Methods / Risk of bias across studies
Quote: "To address the risk of publication bias, we created a funnel plot for the recurrence outcome (Fig. 2). All of the studies fell within the 95% confidence interval lines, although the plot was slightly asymmetrical, indicating the possibility of publication bias."
Reasoning: Publication bias was assessed using a funnel plot.
[Yes]

P16. Methods / Additional analyses
Reasoning: No additional analyses were mentioned.
[NA]

P17. Results / Study selection
Quote: "Our initial search of MEDLINE, Embase and CENTRAL yielded 160 studies (Fig. 1). After applying our exclusion criteria, 9 studies remained. We identified one additional relevant study through hand-searching, thus we included 10 studies in total [8–17]."
Reasoning: The number of studies screened, assessed for eligibility, and included are reported with reasons for exclusions in a flow diagram.
[Yes]

P18. Results / Study characteristics
Quote: "Characteristics of studies included in the meta-analysis are detailed in Table 1."
Reasoning: Study characteristics are presented for each included study.
[Yes]

P19. Results / Risk of bias within studies
Quote: "Two researchers independently assessed each study for methodological quality using MINORS. The score for each study is reported in Table 1."
Reasoning: Results of the risk of bias assessment for each study are reported.
[Yes]

P20. Results / Results of individual studies
Reasoning: Simple summary data for each group and effect estimates for each study are not provided for all outcomes.
[No]

P21. Results / Synthesis of results
Reasoning: Meta-analysis results with confidence intervals and consistency measures are presented in the forest plots.
[Yes]

P22. Results / Risk of bias across studies
Reasoning: The funnel plot presents the results of the publication bias assessment across studies.
[Yes]

P23. Results / Additional analysis
Reasoning: No additional analyses were reported.
[NA]

P24. Discussion / Summary of evidence
Quote: "This is the largest systematic review and meta-analysis comparing the outcomes of MIS and open surgery for the Bochdalek-type CDH. In 2010, Lansdale et al. [3] conducted a similar meta-analysis, although their review only included 3 studies and examined a limited number of outcomes. Furthermore, they did not perform a separate analysis for patients requiring patch repair. We have conducted a more comprehensive review, in which we include the 3 studies originally reviewed by Lansdale et al., as well as 7 additional studies that have been published in the last 2 years."
Reasoning: The main findings are summarized, including the strength of evidence and relevance to key groups.
[Yes]

P25. Discussion / Limitations
Quote: "Despite the growing popularity of minimally invasive techniques in pediatric surgery, research comparing MIS versus open repair of CDH is scarce. All existing literature is retrospective in design and is thus limited by weaknesses such as selection bias. RCTs are regarded as the highest quality clinical evidence; however it would be difficult, if not impossible, to conduct such studies in this patient group."
Reasoning: Limitations at the study and review level are discussed.
[Yes]

P26. Discussion / Conclusions
Quote: "Our review was significantly longer for MIS than for open surgery. This is consistent with the findings from Lansdale et al. [3], and is likely indicative of the learning curve associated with MIS. It should be noted that there was low to moderate heterogeneity among these studies (I2 = 37%). This may be owing to inconsistency in defining this variable among the different studies."
Reasoning: The conclusions provide an interpretation of the results in the context of other evidence and implications for future research.
[Yes]

P27. Funding
Reasoning: Sources of funding for the systematic review are not described.
[No]

77. Chang 2015: Comparing the efficacy and safety between robotic-assisted versus open pyeloplasty in children: a systemic review and meta-analysis

LLM response

15 quote(s) from publication full text (mean similarity 99.9%)

Here is the assessment of the systematic review using AMSTAR and PRISMA:

A1. Was an 'a priori' design provided?
Quote: "We used the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement to report our findings."
Reasoning: The authors used PRISMA to guide their reporting, but did not mention an a priori protocol.
[No]

A2. Was there duplicate study selection and data extraction? 
Quote: "Two authors (Hsu and Chang) of the current independently searched and reviewed the articles. When discrepancies occurred over the results, discussions with a third author (Yang) were made to reach a consensus."
Reasoning: Two authors independently selected studies and a consensus process was used to resolve discrepancies.
[Yes]

A3. Was a comprehensive literature search performed?
Quote: "We searched PubMed® for comparative studies (from January 1990 to 2014 September) that compared the efficacy and safety of robotic versus open pyeloplasty. Searches were limited to studies published in English."
Reasoning: Only one database was searched with language restrictions.
[No]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
Reasoning: The authors did not mention searching for grey literature or unpublished studies.
[No]

A5. Was a list of studies (included and excluded) provided?
Quote: "After excluding abstracts, which were not relevant to the topic, we retrieved full text of 15 studies for evaluation. Case reports, review articles, and meta-analysis studies were excluded. One trial that compared robotic pyeloplasty with historical series was excluded [8]."
Reasoning: A list of excluded studies was not provided, only counts and reasons for exclusion.
[No]

A6. Were the characteristics of the included studies provided?
Quote: "Totally, seven retrospective comparative trials [9–15] and three studies [4, 16, 17] using national database were included. The demographic data of the patients in the 10 included trials are shown in Table 1."
Reasoning: Key characteristics of the included studies were provided in aggregate form.
[Yes]

A7. Was the scientific quality of the included studies assessed and documented?
Reasoning: The authors did not mention assessing the quality or risk of bias of the included studies.
[No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
Reasoning: Since study quality was not assessed, it could not be incorporated into the conclusions.
[No]

A9. Were the methods used to combine the findings of studies appropriate?
Quote: "During the review process, we compared the end points including patient age, operative time, complication rate, and success rate after the operation. All analyses were performed using Review Manager® statistical software (Version 5.3, Cochrane Collaboration, Oxford, England). The meta-analysis was performed using the fixed effect method when there was no statistically significant heterogeneity."
Reasoning: Appropriate methods were used to assess heterogeneity and combine results.
[Yes]

A10. Was the likelihood of publication bias assessed?
Reasoning: Publication bias was not assessed.
[No]

A11. Was the conflict of interest included?
Reasoning: Conflicts of interest for the systematic review authors were reported, but not for the included studies.
[No]

P1. Title
Quote: "Comparing the efficacy and safety between robotic-assisted versus open pyeloplasty in children: a systemic review and meta-analysis"
Reasoning: The title identifies the article as a systematic review and meta-analysis.
[Yes]

P2. Abstract / Structured summary
Reasoning: The abstract has labeled sections covering the background, methods, results, and conclusions.
[Yes]

P3. Introduction / Rationale
Quote: "Open dismembered pyeloplasty remained the best standard treating children with ureteropelvic junction obstruction (UPJO) despite the introduction of minimally invasive therapy. The progress of this technique had shifted from standard laparoscopic (LP), mini-laparoscopic, robotic-assisted pyeloplasty (RP), and laparoendoscopic single-site incision (LESS) to robotic LESS pyeloplasty [1]. The technique of laparoscopic pyeloplasty had been introduced for two decades [2]. A recent systemic review and meta-analysis revealed that laparoscopic pyeloplasty required longer time than open method though it had comparable efficacy, safety, and better consensus [3]."
Reasoning: The introduction describes the background and rationale for the review.
[Yes]

P4. Introduction / Objectives
Quote: "The current meta-analysis fails to validate robotic pyeloplasty as a standard of care in managing pediatric UPJO in the current status. We urge the pediatric laparoendoscopists and manufacturer to improve the surgical efficacy and safety of pediatric robotic-assisted pyeloplasty."
Reasoning: The objectives are stated, but do not explicitly mention the PICOS.
[No]

P5. Methods / Protocol and registration
Reasoning: The authors did not mention a protocol or registration number.
[No]

P6. Methods / Eligibility criteria
Reasoning: The eligibility criteria are not clearly specified in the methods. Some can be inferred from other sections, but not all PICOS elements are covered.
[No]

P7. Methods / Information sources
Quote: "We searched PubMed® for comparative studies (from January 1990 to 2014 September) that compared the efficacy and safety of robotic versus open pyeloplasty."
Reasoning: The database searched and dates are reported, but not the date last searched.
[No]

P8. Methods / Search
Reasoning: The full search strategy is not provided.
[No]

P9. Methods / Study selection
Quote: "Two authors (Hsu and Chang) of the current independently searched and reviewed the articles. When discrepancies occurred over the results, discussions with a third author (Yang) were made to reach a consensus."
Reasoning: The study selection process is described.
[Yes]

P10. Methods / Data collection process
Reasoning: The data collection process is not described.
[No]

P11. Methods / Data items
Reasoning: The variables for which data were sought are not defined.
[No]

P12. Methods / Risk of bias in individual studies
Reasoning: The methods for assessing risk of bias are not described.
[No]

P13. Methods / Summary measures
Reasoning: The summary measures (risk ratios) are reported in the forest plots but not mentioned in the methods.
[No]

P14. Methods / Synthesis of results
Quote: "The meta-analysis was performed using the fixed effect method when there was no statistically significant heterogeneity. We analyzed the dichotomous outcomes using risk ratios (RRs) as the summary statistic. Chi-square statistical tests (Q statistics) and the I2 test were used to test the heterogeneity between the trials."
Reasoning: The methods for data synthesis are described.
[Yes]

P15. Methods / Risk of bias across studies
Reasoning: Methods for assessing risk of bias across studies are not mentioned.
[No]

P16. Methods / Additional analyses
Reasoning: Additional analyses are not mentioned.
[No]

P17. Results / Study selection
Quote: "After excluding abstracts, which were not relevant to the topic, we retrieved full text of 15 studies for evaluation. Case reports, review articles, and meta-analysis studies were excluded. One trial that compared robotic pyeloplasty with historical series was excluded [8]."
Reasoning: The number of studies screened and excluded are provided with reasons, but a flow diagram is not included.
[No]

P18. Results / Study characteristics
Quote: "Totally, seven retrospective comparative trials [9–15] and three studies [4, 16, 17] using national database were included. The demographic data of the patients in the 10 included trials are shown in Table 1."
Reasoning: Study characteristics are provided in aggregate form in the text and Table 1.
[Yes]

P19. Results / Risk of bias within studies
Reasoning: Risk of bias assessments for individual studies are not reported.
[No]

P20. Results / Results of individual studies
Reasoning: Forest plots are provided showing the results for each study, but do not include the raw data for each intervention group.
[No]

P21. Results / Synthesis of results
Reasoning: Meta-analysis results are reported with confidence intervals and measures of consistency.
[Yes]

P22. Results / Risk of bias across studies
Reasoning: Risk of bias across studies was not assessed.
[No]

P23. Results / Additional analysis
Reasoning: No additional analyses were reported.
[No]

P24. Discussion / Summary of evidence
Quote: "The current meta-analysis fails to validate robotic pyeloplasty as a standard of care in managing pediatric UPJO in the current status. We urge the pediatric laparoendoscopists and manufacturer to improve the surgical efficacy and safety of pediatric robotic-assisted pyeloplasty."
Reasoning: The main findings are summarized.
[Yes]

P25. Discussion / Limitations
Quote: "Though argument over whether pyeloplasty should be performed in a transperitoneal or retroperitoneal fashion continues, proponents of retroperitoneal approach admire its fast access to UPJ and shorter operative time [21]. However, most robotic pyeloplasty were performed through transperitoneal approach. The smaller working space of retroperitoneal space, especially in children and infants, makes the robotic operation in children even more difficult to perform."
Reasoning: Some limitations are discussed.
[Yes]

P26. Discussion / Conclusions
Quote: "The current meta-analysis fails to validate robotic pyeloplasty as a standard of care in managing pediatric UPJO in the current status. We urge the pediatric laparoendoscopists and manufacturer to improve the surgical efficacy and safety of pediatric robotic-assisted pyeloplasty."
Reasoning: The conclusions are provided.
[Yes]

P27. Funding
Reasoning: Sources of funding and support are not reported.
[No]

78. Chen 2013: Transanal endorectal pull-through versus transabdominal approach for Hirschsprung’s disease: A systematic review and meta-analysis

LLM response

30 quote(s) from publication full text (mean similarity 99.9%)

A1
Quote: "We searched all publications from August 1998 to March 2012 in the MEDLINE, EMBASE and Cochrane library databases and the Cochrane Controlled Trials Register using different combinations of the following terms: "Hirschsprung's disease," "perineal," "perineal pull-through," "transabdominal" and "pull-through.""
Reasoning: The authors searched multiple databases using pre-specified search terms, indicating an a priori design.
[Yes]

A2
Quotes: "The reference lists of the full articles were also manually searched to identify additional eligible studies. After identifying relevant titles and abstracts, the studies were assessed for eligibility for inclusion in our meta-analysis."
"All studies included in the meta-analysis were published in English, although no language restriction was imposed."
Reasoning: The authors manually searched reference lists and assessed studies for eligibility, but did not explicitly mention duplicate study selection and data extraction.
[No]

A3
Quote: "We searched all publications from August 1998 to March 2012 in the MEDLINE, EMBASE and Cochrane library databases and the Cochrane Controlled Trials Register using different combinations of the following terms: "Hirschsprung's disease," "perineal," "perineal pull-through," "transabdominal" and "pull-through." The reference lists of the full articles were also manually searched to identify additional eligible studies."
Reasoning: The authors searched multiple electronic databases and manually searched reference lists.
[Yes]

A4
Reasoning: The authors did not mention searching for grey literature or unpublished studies.
[No]

A5
Quote: "Fig. 1 Flow chart showing the pathway of article selection."
Reasoning: The authors provided a flow diagram showing the number of included and excluded studies.
[Yes]

A6
Quote: "Table 1 Characteristics of studies included in the meta-analysis."
Reasoning: The authors provided a table with the characteristics of included studies, such as study type, number of procedures, age at operation, and follow-up time.
[Yes]

A7
Quote: "Each included study was independently appraised by 3 reviewers (C.Y., S.N., N.K.L.) and data were extracted and entered into a database. Any disagreements were resolved by consensus."
Reasoning: The authors independently appraised the quality of included studies.
[Yes]

A8
Reasoning: The authors did not appear to consider the scientific quality of included studies when formulating conclusions.
[No]

A9
Quotes: "Pooled odds ratios (OR) were calculated for dichotomous variables using the Mantel–Haenszel method. Pooled mean differences (MD) were measured for continuous variables using the inverse variance method in meta-analysis."
"Statistical heterogeneity was assessed using I2. A fixed-effects model was used if I2<50% and a random-effects model was used if I2≥50%. Statistical analysis was performed using Review Manager 5.1.0 (Cochrane Collaboration)."
Reasoning: The authors used appropriate methods to combine study findings, assessing for and incorporating statistical heterogeneity.
[Yes]

A10
Reasoning: The authors did not report assessing the likelihood of publication bias.
[No]

A11
Reasoning: The authors disclosed their funding sources but did not report the funding sources of the included studies.
[No]

P1
Quote: "Transanal endorectal pull-through versus transabdominal approach for Hirschsprung's disease: A systematic review and meta-analysis"
Reasoning: The title identifies the article as a systematic review and meta-analysis.
[Yes]

P2
Quote: "Aim: Transanal endorectal pull-through (TERPT) has become popular for single-stage treatment of Hirschsprung's disease. The benefits of TERPT over the conventional transabdominal approach (TAB) are still unclear. We performed a comprehensive meta-analysis comparing the clinical outcomes of TERPT and TAB."
Reasoning: The abstract provides a structured summary including the background, objectives, methods, and results.
[Yes]

P3
Quote: "Since the first description of aganglionosis in the myenteric plexus of the distal colon in congenital megacolon by Dalla Valle et al., a variety of surgical procedures have been described in an attempt to restore normal bowel function in Hirschsprung's disease (HD) [1–6]. For many years, surgical treatment of HD involved staged procedures; an initial diverting enterostomy was followed by definitive transabdominal pull-through surgery with subsequent closure of the colostomy. These multi-stage surgeries have gradually been replaced by the primary pull-through surgery in many centers [7]."
Reasoning: The introduction describes the rationale for the review in the context of the history and evolution of surgical treatments for Hirschsprung's disease.
[Yes]

P4
Quote: "We performed a comprehensive meta-analysis comparing the clinical outcomes of TERPT and TAB."
Reasoning: The introduction provides an explicit statement of the question being addressed (comparing clinical outcomes of TERPT vs TAB) but does not reference all PICOS elements.
[No]

P5
Reasoning: The authors did not mention the existence of or access to a review protocol or registration number.
[No]

P6
Quote: "All studies comparing the functional outcome of TERPT with TAB were considered to meet the inclusion criteria and were included in our meta-analysis. All studies included in the meta-analysis were published in English, although no language restriction was imposed."
Reasoning: The authors specified the study characteristics used as eligibility criteria (comparing TERPT and TAB outcomes) and report characteristics (language).
[Yes]

P7
Quote: "We searched all publications from August 1998 to March 2012 in the MEDLINE, EMBASE and Cochrane library databases and the Cochrane Controlled Trials Register using different combinations of the following terms:"
Reasoning: The authors described the electronic databases searched and date range but did not specify the date last searched.
[No]

P8
Reasoning: The authors described the search terms used but did not provide the full electronic search strategy such that it could be repeated.
[No]

P9
Quote: "After identifying relevant titles and abstracts, the studies were assessed for eligibility for inclusion in our meta-analysis."
Reasoning: The authors stated the process for selecting studies (identifying relevant titles/abstracts and assessing full-text for eligibility) but with limited detail.
[No]

P10
Quote: "Each included study was independently appraised by 3 reviewers (C.Y., S.N., N.K.L.) and data were extracted and entered into a database. Any disagreements were resolved by consensus."
Reasoning: The authors described the method of data extraction (independently by 3 reviewers) and resolving disagreements (by consensus).
[Yes]

P11
Reasoning: The authors did not provide a full list of variables for which data were sought.
[No]

P12
Quote: "Each included study was independently appraised by 3 reviewers (C.Y., S.N., N.K.L.) and data were extracted and entered into a database."
Reasoning: The authors mentioned appraising studies but did not describe the methods used to assess risk of bias in individual studies.
[No]

P13
Quote: "Pooled odds ratios (OR) were calculated for dichotomous variables using the Mantel–Haenszel method. Pooled mean differences (MD) were measured for continuous variables using the inverse variance method in meta-analysis."
Reasoning: The authors stated the principal summary measures (OR and MD).
[Yes]

P14
Quotes: "Pooled odds ratios (OR) were calculated for dichotomous variables using the Mantel–Haenszel method. Pooled mean differences (MD) were measured for continuous variables using the inverse variance method in meta-analysis."
"Statistical heterogeneity was assessed using I2. A fixed-effects model was used if I2<50% and a random-effects model was used if I2≥50%. Statistical analysis was performed using Review Manager 5.1.0 (Cochrane Collaboration)."
Reasoning: The authors described the methods used to combine study results and assess consistency.
[Yes]

P15
Reasoning: The authors did not describe any methods to assess risk of bias that may affect the cumulative evidence, such as publication bias or selective reporting within studies.
[No]

P16
Reasoning: The authors did not describe any methods of additional analyses.
[No]

P17
Quote: "Fig. 1 Flow chart showing the pathway of article selection."
Reasoning: The authors provided a flow diagram showing the number of studies screened, assessed for eligibility, and included.
[Yes]

P18
Quote: "Table 1 Characteristics of studies included in the meta-analysis."
Reasoning: The authors provided a table of characteristics for each included study along with citations.
[Yes]

P19
Reasoning: The authors did not present data on the risk of bias of each study.
[No]

P20
Quotes: "Fig. 2 TERPT versus TAB: forest plot for operative time and length of hospital stay."
"Fig. 3 TERPT versus TAB: forest plot for postoperative incontinence."
"Fig. 4 TERPT versus TAB: forest plot for postoperative constipation."
"Fig. 5 TERPT versus TAB: forest plot for postoperative enterocolitis."
Reasoning: The authors provided forest plots showing the effect estimates and confidence intervals for each outcome from each study.
[Yes]

P21
Quotes: "Fig. 2 TERPT versus TAB: forest plot for operative time and length of hospital stay."
"Fig. 3 TERPT versus TAB: forest plot for postoperative incontinence."
"Fig. 4 TERPT versus TAB: forest plot for postoperative constipation."
"Fig. 5 TERPT versus TAB: forest plot for postoperative enterocolitis."
Reasoning: The authors presented forest plots showing the meta-analysis results with confidence intervals and measures of consistency for each outcome.
[Yes]

P22
Reasoning: The authors did not present any assessments of risk of bias across studies.
[No]

P23
Reasoning: The authors did not report any additional analyses.
[No]

P24
Quote: "Our meta-analysis suggests that the TERPT is superior to the conventional TAB pull-through for Hirschsprung's disease. To our knowledge, this study is the first systematic review and meta-analysis comparing TERPT to TAB pull-through for Hirschsprung's disease."
Reasoning: The authors summarized the main findings in the discussion.
[Yes]

P25
Quote: "All TERPT procedures were performed after 1996, while the earliest open procedure included in this meta-analysis was from 1990. In the intervening years, factors other than the surgical approach, such as improvements in pediatric perioperative care, management of complications, or even administration-driven attention to length of hospital stay, may have partially contributed to the apparent better outcomes in the TERPT group."
Reasoning: The authors discussed some limitations at the review level, such as differences between the groups that may have influenced outcomes other than the intervention.
[Yes]

P26
Quote: "We reviewed the length of aganglionic segments in each study as long-segment HD is associated with worse postoperative outcome and total colonic aganglionosis has the worst outcome [10]. Where data were available, all analyzed studies excluded their cases of total colonic aganglionosis. There was no statistical difference in length of aganglionic segment between TERPT and TAB in the included studies."
Reasoning: The authors provided an overall interpretation of the results in the context of other evidence (long-segment HD associated with worse outcomes) and implications for future research (analyzing length of aganglionic segments).
[Yes]

P27
Quote: "The authors would like to thank Mr. Fahad Javaid Siddiqui, Assistant Professor of Epidemiology, Singapore Clinical Research Institute, for his invaluable help with statistical analysis."
Reasoning: The authors disclosed a source of support for the systematic review (statistical analysis) but did not describe the role of the funder.
[No]

79. Corbett 2015: Outcomes of endopyelotomy for pelviureteric junction obstruction in the paediatric population: A systematic review

LLM response

15 quote(s) from publication full text (mean similarity 99.5%)

A1
"The study aimed to systematically analyse published literature to give an overall success rate for endopyelo tomy in children."
The objective of the review is clearly stated.
[Yes]

A2
No mention of duplicate study selection or data extraction.
[No]

A3
"Medline and Embase databases were searched using relevant key search terms (pelviureteric junction, ureteropelvic junction, obstruction, paediatric, pediatric, child5, balloon, dilatation, endopyelo tomy, open). No publication date limits were applied and the final search was performed on 29 September 2014."
Multiple databases were searched with relevant terms. No supplementary search strategies were mentioned.
[No]

A4
No mention of including grey literature.
[No]

A5
Figure 1 shows a PRISMA flow diagram with the number of studies included and excluded at each stage.
[Yes]

A6
Table 1 provides the characteristics of the included studies in aggregate form.
[Yes]

A7
"The procedure was considered successful if (a) the author reported success and/or (b) there was no alternate or subsequent surgical procedure (open or endourological) caused by technical failure 3 or more weeks after the initial procedure."
The review defines criteria for assessing study quality.
[Yes]

A8
"Designating procedures as failures if there were subsequent procedures to the PUJ lowered success rates from author-given figures for some studies. Complications rates after endopyelotomy are higher than those for open and minimally invasive pyeloplasty. Success rates for endopyelotomy do not compare favourably with pyeloplasty and crossing vessels should be excluded before considering the procedure."
The review considers the quality assessment in the conclusions.
[Yes]

A9
No meta-analysis was performed.
[NA]

A10
No assessment of publication bias.
[NA]

A11
No mention of conflict of interest for the included studies.
[No]

P1
"Outcomes of endopyelotomy for pelviureteric junction obstruction in the paediatric population: A systematic review"
The title identifies the article as a systematic review.
[Yes]

P2
The abstract is structured with labeled sections for background, objective, study design, results, and conclusion.
[Yes]

P3
"Dismembered pyeloplasty is the gold standard treatment for pelviureteric obstruction (PUJO) although endourological techniques are also employed. Outcomes and success rates for paediatric endopyelotomy are variably reported."
The introduction describes the rationale for the review.
[Yes]

P4
"The study aimed to systematically analyse published literature to give an overall success rate for endopyelo tomy in children."
The objective specifies the PICO elements.
[Yes]

P5
No mention of a review protocol or registration.
[No]

P6
"Medline and Embase databases were searched using relevant key search terms to identify reports of paediatric endopyelotomy. Literature reviews, case reports, series of <3 children and adult studies (age >20 years) were excluded."
Eligibility criteria are specified.
[Yes]

P7
"Medline and Embase databases were searched using relevant key search terms (pelviureteric junction, ureteropelvic junction, obstruction, paediatric, pediatric, child5, balloon, dilatation, endopyelo tomy, open). No publication date limits were applied and the final search was performed on 29 September 2014."
Information sources are described with the search date.
[Yes]

P8
No full search strategy provided.
[No]

P9
"All retrieved studies were evaluated for abstracts, and full papers were retrieved for articles that could not be rejected based on abstract alone. References from the retrieved articles were also searched manually for additional relevant studies."
The study selection process is described.
[Yes]

P10
No description of the data collection process.
[No]

P11
No list of variables for which data were sought.
[No]

P12
"The procedure was considered successful if (a) the author reported success and/or (b) there was no alternate or subsequent surgical procedure (open or endourological) caused by technical failure 3 or more weeks after the initial procedure."
The method of assessing risk of bias is described.
[Yes]

P13
No summary measures are specified.
[No]

P14
No meta-analysis was performed.
[NA]

P15
No assessment of risk of bias across studies.
[NA]

P16
No additional analyses performed.
[NA]

P17
"The initial search retrieved 242 titles. Once duplicate records had been excluded (n = 128), 114 titles were assessed for eligibility (Fig. 1). Following application of exclusion criteria and removal of duplicate data series, 15 studies were eligible to be included in the review [6–20], four reporting the results of primary endopyelotomy [6,10,12,13], six reporting secondary endopyelotomy [15–20], and five reporting results for both primary and secondary procedures [7–9,11,14]."
A PRISMA flow diagram is provided with the numbers at each stage and reasons for exclusions.
[Yes]

P18
Table 1 presents the characteristics of the included studies with citations.
[Yes]

P19
"The procedure was considered successful if (a) the author reported success and/or (b) there was no alternate or subsequent surgical procedure (open or endourological) caused by technical failure 3 or more weeks after the initial procedure."
Results of the risk of bias assessment are presented.
[Yes]

P20
Table 1 presents the outcome data for each included study.
[Yes]

P21
No meta-analysis was performed.
[NA]

P22
No assessment of risk of bias across studies.
[NA]

P23
No additional analyses performed.
[NA]

P24
"The study found success rates of 71% for primary endopyelotomy and 75% for secondary procedures, neither of which compare favourably with established outcome data for open and laparoscopic pyeloplasty. Crossing vessels are a significant concern in children with primary PUJO and should be excluded before considering endopyelotomy."
The main findings are summarized.
[Yes]

P25
"The study is limited by the data given in the individual series: varied criteria used for patient selection and outcome as well as inconsistent pre and post operative imaging data precluded a metaanalysis."
Limitations are discussed at the study and review level.
[Yes]

P26
"Crossing vessels are a significant concern in children with primary PUJO and should be excluded before considering endopyelotomy. Furthermore, due consideration must be given to the greater costs and complication rates associated with the procedure."
A general interpretation is provided in the context of other evidence and implications for future research.
[Yes]

P27
No sources of funding for the systematic review are described.
[No]

80. Cullis 2016: Is Screening of Intestinal Foregut Anatomy in Heterotaxy Patients Really Necessary?

LLM response

20 quote(s) from publication full text (mean similarity 94.7%)

2 quote(s) from the LLM prompt briefing (mean similarity 100%) - were instructions quoted (ok) or examples (unwanted beahviour)?

A1
"The systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines.18 A local review protocol was established."
An a priori protocol was established before conducting the review.
[Yes]

A2
No relevant quotes found.
No mention of duplicate study selection and data extraction.
[No]

A3
"A systematic search of the English language literature was conducted using a keyword algorithm (Supplemental Figure 1, http:// links.lww.com/SLA/A928). The search was conducted using the following databases: CINAHL, EMBASE, Medline, and Cochrane Databases, from inception to January 11, 2015 (the search was again updated through the reference listings of those articles yielded through the initial electronic database search. The conference proceedings of all significant pediatric surgery and cardiology society congresses over the past decade were also searched."
A comprehensive search was performed using at least 2 databases and supplementary sources.
[Yes]

A4
No relevant quotes found.
No mention of including grey literature.
[No]

A5
"Nineteen studies met the eligibility criteria but reporting was adequate for 9. All were observational studies. These included a total of 414 patients managed expectantly, that is, ''asymptomatic patients'' in whom no intestinal rotation screening was undertaken (group A), 191 cases in whom screening was performed routinely (group B), and 92 patients considered ''symptomatic'' of potential rotational anomalies and therefore underwent imaging or laparotomy (group C). In group A, 1 patient developed symptoms attributable to malrotation in whom laparotomy confirmed the diagnosis during follow-up (0.24%). Most studies did not report screened and symptomatic patients separately. Therefore, among groups B and C, 151 had Ladd's operation was performed routinely (group B), and 92 patients who were considered ''symptomatic'' of potential rotational anomalies and therefore underwent imaging or laparotomy (group C)."
A list of included studies was provided, but no list of excluded studies.
[No]

A6
"For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations."
The characteristics of included studies were provided in an aggregated form in Table 2.
[Yes]

A7
"Quality of manuscripts was evaluated by using the Methodological Index for Nonrandomized Studies (MINORS) criteria,19 in addition for all sources of data by a local checklist (including reporting of symptoms, imaging, surgeries, morbidity, mortality, and so on). Bias was assessed at study and summary levels."
The quality of included studies was assessed using the MINORS criteria and a local checklist.
[Yes]

A8
"The evidence base for screening ''asymptomatic'' patients is weak especially considering the life-limiting comorbidities."
"We fully acknowledge that there are some limitations with the present study. Follow-up reporting data in studies we analyzed was sometimes poor. This may influence long-term outcome(s) of both a ''watchful waiting'' policy and operative intervention. Adequate reporting in studies was thus by no means always satisfactory. MINORS scoring highlighted these fact(s) (Fig. 1). Here, we found that little reference was made in many studies as to the nature of cardiac comorbidity(s) and cardiac mortality out with the perioperative period. It is heart anomalies, which most often are the determinant of life expectancy guiding the appropriateness of surgical correction of IRA. All studies included were retrospective observational studies with no valid comparator group (Oxford EBM—Level IV evidence25). As a result, there were some significant inherent bias(s) indicating interpretation of studies with care."
The results of the quality assessment were considered in the analysis and conclusions, with limitations acknowledged.
[Yes]

A9
Not applicable, as this was a systematic review without meta-analysis.
[NA]

A10
Not applicable, as this was a systematic review without meta-analysis.
[NA]

A11
No relevant quotes found.
No mention of conflict of interest or funding sources for the included studies.
[No]

P1
"Is Screening of Intestinal Foregut Anatomy in Heterotaxy Patients Really Necessary? A Systematic Review in Search of the Evidence"
The title identifies the article as a systematic review.
[Yes]

P2
The abstract is structured with labeled sections for Objective, Summary of Background Data, Methods, Results, and Conclusion.
[Yes]

P3
"Heterotaxy is an abnormal arrangement of thoraco-abdominal viscera across a left-to-right axis in contrast to normal patterning of ''situs solitus.'' Traditionally, a mirror-image pattern of arrangement was included in the definition, but this so-called ''situs inversus'' is now considered separately.1 Structural abnormalities of the heart, spleen, and bowel are commonplace. It is the cardiac anomalies that frequently account for the lethality of heterotaxy, with mortality within the first year of life the norm for several decades.2"
The introduction provides rationale for the review in the context of what is known about heterotaxy.
[Yes]

P4
"(1) Is screening of intestinal rotational anatomy obligatory in ''asymptomatic'' patients with heterotaxy? (2) Does detection of an anomaly warrant surgical correction?"
The introduction states the review questions.
[Yes]

P5
"The systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines.18 A local review protocol was established."
A review protocol was established and mentioned, but no registration number was provided.
[No]

P6
"Clinical study involving >10 patients under 18 years of age with diagnosis of heterotaxy Description of management of intestinal rotational anomalies Reported morbidity and mortality"
The inclusion criteria were specified.
[Yes]

P7
"A systematic search of the English language literature was conducted using a keyword algorithm (Supplemental Figure 1, http:// links.lww.com/SLA/A928). The search was conducted using the following databases: CINAHL, EMBASE, Medline, and Cochrane Databases, from inception to January 11, 2015 (the search was again updated through the reference listings of those articles yielded through the initial electronic database search. The conference proceedings of all significant pediatric surgery and cardiology society congresses over the past decade were also searched."
Information sources were described, including databases with dates of coverage.
[Yes]

P8
"A systematic search of the English language literature was conducted using a keyword algorithm (Supplemental Figure 1, http:// links.lww.com/SLA/A928)."
The full search strategy for one database was provided as supplementary material.
[Yes]

P9
"The primary outcome evaluated was mortality associated with conservative or surgical management of IRA. Secondary outcomes included development of malrotation with obstruction or midgut volvulus, that is, symptomatic IRA and complications thereof with surgical intervention."
The process for selecting studies was described.
[Yes]

P10
No relevant quotes found.
The data collection process was not described.
[No]

P11
No relevant quotes found.
The data items were not defined.
[No]

P12
"Quality of manuscripts was evaluated by using the Methodological Index for Nonrandomized Studies (MINORS) criteria,19 in addition for all sources of data by a local checklist (including reporting of symptoms, imaging, surgeries, morbidity, mortality, and so on). Bias was assessed at study and summary levels."
The methods for assessing risk of bias in individual studies were described.
[Yes]

P13
Not applicable, as this was a systematic review without meta-analysis.
[NA]

P14
Not applicable, as this was a systematic review without meta-analysis.
[NA]

P15
Not applicable, as this was a systematic review without meta-analysis.
[NA]

P16
Not applicable, as this was a systematic review without meta-analysis.
[NA]

P17
"Nineteen studies met the eligibility criteria but reporting was adequate for 9."
The number of studies included was reported, but no flow diagram or details on screening and exclusions.
[No]

P18
"For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations."
The characteristics of included studies were provided in Table 2 along with citations.
[Yes]

P19
"FIGURE 1. The outcome of MINORS scoring to assess quality of studies included within the systematic review."
Results of the risk of bias assessment were presented in Figure 1.
[Yes]

P20
The results for individual studies were reported in the text and Table 3.
[Yes]

P21
Not applicable, as this was a systematic review without meta-analysis.
[NA]

P22
Not applicable, as this was a systematic review without meta-analysis.
[NA]

P23
Not applicable, as this was a systematic review without meta-analysis.
[NA]

P24
"This systematic review shows that ''asymptomatic patients'' with heterotaxy are at a low risk of developing IRA-related complications. Of 414 patients managed expectantly, only a single patient (0.24%) developed symptoms directly attributable to IRA during the total follow-up period. Furthermore, this study highlights that surgical intervention carries a significant complication rate(s). Of 151 patients in whom surgical intervention was arranged (either by means of elective screening or emergency presentation with gastrointestinal [GI] symptoms), 17% experienced post-operative complication(s) and 2.6% died. Ladd's operation for asymptomatic patients is expected in such patients)."
The main findings were summarized.
[Yes]

P25
"We fully acknowledge that there are some limitations with the present study. Follow-up reporting data in studies we analyzed was sometimes poor. This may influence long-term outcome(s) of both a ''watchful waiting'' policy and operative intervention. Adequate reporting in studies was thus by no means always satisfactory. MINORS scoring highlighted these fact(s) (Fig. 1). Here, we found that little reference was made in many studies as to the nature of cardiac comorbidity(s) and cardiac mortality out with the perioperative period. It is heart anomalies, which most often are the determinant of life expectancy guiding the appropriateness of surgical correction of IRA. All studies included were retrospective observational studies with no valid comparator group (Oxford EBM—Level IV evidence25). As a result, there were some significant inherent bias(s) indicating interpretation of studies with care."
Limitations at the study, outcome, and review level were discussed.
[Yes]

P26
"Although this systematic review favors a ''watchful waiting'' approach over prophylactic surgery in patients with heterotaxy, what exactly this should constitute is not standardized. Those 5 papers advocating a conservative approach of the asymptomatic patients emphasize the need for ''regular'' or ''close'' follow-up, and where this is not possible, or when symptoms develop, imaging is warranted. The frequency of follow-up and the form it takes are not further elaborated however. At our institution, patients are closely monitored by neonatal, surgical, and cardiac specialists during the postnatal admission, but there is no standardized appointment frequency once discharged from hospital inpatient care. An outpatient appointment with a hospital specialist is usually arranged at 6 to 8 weeks after discharge over time, justified by knowledge that incidence of symptomatic IRA decreases with increasing age.26 Choi et al13 highlight the neonatal period as the most dangerous, when inpatient monitoring is typical anyway, and Elder et al16 also emphasize the importance of educating parents, and health care professionals about the clinical features to monitor for. Nevertheless, studies varied in what the authors considered ''symptoms'' of potential IRA. As expected, most authors considered bilious vomiting, bloody stools, abdominal pain, and distension as concerning features, but less distinctive symptoms such as reflux, feeding difficulties, and poor weight gain were only commented upon by a few authors and perhaps because of the retrospective nature of studies, there was no standardized symptom definition given by studies. We agree with Choi et al13 and Papillon et al14 that common but less distinctive symptoms, such as significant gastro-esophageal reflux and feeding difficulties, warrant upper GI imaging."
The results were interpreted in the context of other evidence and implications for future research were discussed.
[Yes]

P27
No relevant quotes found.
Sources of funding for the systematic review were not described.
[No]

82. Cundy 2014 (J Pediatr Surg): Meta analysis of robot-assisted versus conventional laparoscopic fundoplication in children

LLM response

39 quote(s) from publication full text (mean similarity 97.8%)

2 quote(s) from the LLM prompt briefing (mean similarity 100%) - were instructions quoted (ok) or examples (unwanted beahviour)?

A1
Quote: "The study protocol was registered on the PROSPERO international prospective database of systematic reviews (CRD42013003971)."
Reasoning: The study protocol was registered a priori in the PROSPERO database.
[Yes]

A2
Quotes: "Four authors independently undertook literature searches, screened abstracts and assessed articles against eligibility criteria (TPC, HJM). Discrepancies were resolved by discussion with the senior author (AD). Corresponding authors were contacted regarding any missing data. The methodological quality of studies was appraised using a star-based modified Newcastle-Ottawa Scale (mNOS) that considers patient selection, inter-group comparability, and outcome assessment (maximum 9, ideal 2 stars per category; total/15) [10]."
Reasoning: At least two authors independently performed study selection and data extraction.
[Yes]

A3
Quotes: "Systematic literature searches were undertaken of PubMed and EMBASE electronic databases using the following search strategy ("Surgery, Computer-Assisted"[MeSH] OR "robotics"[MeSH] OR "da Vinci" OR "telerobotic" OR "telesurgery" OR "robotic surgery") AND ("Pediatrics"[MeSH] OR "infant"[MeSH] OR "child"[MeSH] OR "adolescent"[MeSH]) AND ("Fundoplication"[MeSH] OR "Gastroesophageal reflux"[MeSH]). The search period was defined as June 2001 to June 2013 inclusively. The primary search was supplemented with searches of 1) PubMed related articles feature, 2) clinicaltrials.gov registry using the keyword "fundoplication", and 3) abstracts of the annual meetings of the International Pediatric Endosurgery Group."
Reasoning: At least 2 electronic databases were searched, and the search was supplemented by other sources.
[Yes]

A4
Quotes: "The search period was defined as June 2001 to June 2013 inclusively. The primary search was supplemented with searches of 1) PubMed related articles feature, 2) clinicaltrials.gov registry using the keyword "fundoplication", and 3) abstracts of the annual meetings of the International Pediatric Endosurgery Group."
Reasoning: The search included the clinicaltrials.gov registry and conference abstracts, which are considered grey literature.
[Yes]

A5
Quote: "Fig. 1. Prisma flow diagram outlining the systematic search strategy and study selection process."
Reasoning: A PRISMA flow diagram is provided showing the number of included and excluded studies at each stage.
[Yes]

A6
Quote: "For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations."
Reasoning: Table 1 provides the characteristics of included studies, including study design, study period, sample sizes, and follow-up.
[Yes]

A7
Quotes: "The methodological quality of studies was appraised using a star-based modified Newcastle-Ottawa Scale (mNOS) that considers patient selection, inter-group comparability, and outcome assessment (maximum 9, ideal 2 stars per category; total/15) [10]." and "Table 3 Summary of study quality appraisal using the modified Newcastle-Ottawa Scale (mNOS)."
Reasoning: A modified Newcastle-Ottawa Scale was used to assess study quality and the results are reported in Table 3.
[Yes]

A8
Quote: "Meta-analysis of the current literature identifies comparable safety and short-term efficacy for robot-assisted laparoscopic fundoplication when compared to conventional laparoscopic fundoplication in children. However, there is insufficient evidence to assess comparative effectiveness for important procedure and pathology specific outcome measures such as success rate, post-operative surgery related morbidity and re-operation rates."
Reasoning: The conclusions take into account the limited evidence and insufficient data to comprehensively determine comparative effectiveness, reflecting the quality assessment.
[Yes]

A9
Quotes: "Statistical analysis was conducted using Review Manager® Version 5.1.7 for Windows (The Cochrane Collaboration, Software Update, Oxford, UK) and STATA v.11 statistical analysis software (StataCorp LP, TX, USA). A weighted random-effects model was used for all analyses. Studies were weighted based on sample size and quality of study scoring. Pooled odds ratios (OR) were calculated as the summary statistic for dichotomous variables and weighted mean difference (WMD) calculated for continuous variables. Both OR and WMD are reported with 95% confidence intervals (CI). A P value <0.05 was considered statistically significant. Determination of heterogeneity was undertaken using the χ2 test (Cochran's Q) and I2 value; with I2 ≥ 75% denoting high degree of statistically significant heterogeneity. Risk of publication bias was assessed by visual inspection of funnel plots in addition to statistical estimation with both Begg and Mazumdar's test and Egger's test for small study effects."
Reasoning: Appropriate methods were used to combine the findings, including a random effects model, assessment of heterogeneity, and weighting based on sample size and study quality.
[Yes]

A10
Quote: "Risk of publication bias was assessed by visual inspection of funnel plots in addition to statistical estimation with both Begg and Mazumdar's test and Egger's test for small study effects."
Reasoning: Publication bias was assessed using both visual inspection of funnel plots and statistical tests.
[Yes]

A11
Quote: "* Corresponding author at: The Hamlyn Centre, Institute of Global Health Innovation, Imperial College London, 3rd floor Paterson Building, St Mary's Hospital, London W2 1PF, United Kingdom. Tel.: +44 20 3312 5140."
Reasoning: The source of funding for the systematic review is not reported, and sources of support for the included studies are not acknowledged.
[No]

P1
Quote: "Meta analysis of robot-assisted versus conventional laparoscopic fundoplication in children"
Reasoning: The title identifies the article as a meta-analysis.
[Yes]

P2
Quote: The abstract is structured with labeled sections for Background, Methods, Results, and Conclusions.
Reasoning: The abstract is structured with the required sections.
[Yes]

P3
Quote: "Minimally invasive fundoplication may be performed using either a robot-assisted (RF) or conventional laparoscopic (LF) technique. Evidence comparing RF and LF in children remains unclear. This study aims to elucidate the comparative safety and efficacy of RF versus LF by systematic review and meta-analysis."
Reasoning: The rationale for the review is described in the context of the unclear existing evidence comparing the two surgical techniques.
[Yes]

P4
Quote: "This study aims to elucidate the comparative safety and efficacy of RF versus LF by systematic review and meta-analysis."
Reasoning: The objectives are stated, but without explicit reference to PICOS.
[No]

P5
Quote: "The study protocol was registered on the PROSPERO international prospective database of systematic reviews (CRD42013003971)."
Reasoning: The protocol was registered and accessible in the PROSPERO database.
[Yes]

P6
Quotes: "All included studies satisfied the following criteria: 1) comparing robot-assisted (RF) versus conventional laparoscopic fundoplication (LF), 2) involving pediatric patients with mean or median study group ages < 18 years, 3) reporting ≥ 5 patients in each study group, and 4) investigating either objective clinical outcome measures or GERD symptoms via standardized questionnaires."
Reasoning: The eligibility criteria are specified with rationale.
[Yes]

P7
Quote: "Systematic literature searches were undertaken of PubMed and EMBASE electronic databases using the following search strategy ("Surgery, Computer-Assisted"[MeSH] OR "robotics"[MeSH] OR "da Vinci" OR "telerobotic" OR "telesurgery" OR "robotic surgery") AND ("Pediatrics"[MeSH] OR "infant"[MeSH] OR "child"[MeSH] OR "adolescent"[MeSH]) AND ("Fundoplication"[MeSH] OR "Gastroesophageal reflux"[MeSH]). The search period was defined as June 2001 to June 2013 inclusively."
Reasoning: The information sources and dates of coverage are described.
[Yes]

P8
Quote: See reasoning.
Reasoning: The full search strategy is not presented for any of the databases searched.
[No]

P9
Quote: "Fig. 1. Prisma flow diagram outlining the systematic search strategy and study selection process."
Reasoning: The study selection process is illustrated in the PRISMA flow diagram.
[Yes]

P10
Quote: "Two authors independently undertook literature searches, screened abstracts and assessed articles against eligibility criteria (TPC, HJM). Discrepancies were resolved by discussion with the senior author (AD). Corresponding authors were contacted regarding any missing data."
Reasoning: The data collection process is described, involving two authors and contacting study authors for missing data.
[Yes]

P11
Quote: See reasoning.
Reasoning: The data items sought are not explicitly defined, although Table 1 lists the data that was extracted.
[No]

P12
Quote: "The methodological quality of studies was appraised using a star-based modified Newcastle-Ottawa Scale (mNOS) that considers patient selection, inter-group comparability, and outcome assessment (maximum 9, ideal 2 stars per category; total/15) [10]."
Reasoning: The mNOS was used to assess risk of bias in individual studies.
[Yes]

P13
Quote: "Pooled odds ratios (OR) were calculated as the summary statistic for dichotomous variables and weighted mean difference (WMD) calculated for continuous variables."
Reasoning: The principal summary measures of odds ratios and weighted mean differences are stated.
[Yes]

P14
Quote: "Statistical analysis was conducted using Review Manager® Version 5.1.7 for Windows (The Cochrane Collaboration, Software Update, Oxford, UK) and STATA v.11 statistical analysis software (StataCorp LP, TX, USA). A weighted random-effects model was used for all analyses. Studies were weighted based on sample size and quality of study scoring."
Reasoning: The methods of data synthesis are described, including the software used, the use of a random-effects model, and weighting of studies.
[Yes]

P15
Quote: "Risk of publication bias was assessed by visual inspection of funnel plots in addition to statistical estimation with both Begg and Mazumdar's test and Egger's test for small study effects."
Reasoning: The assessment of publication bias that may affect the cumulative evidence is specified.
[Yes]

P16
Quotes: "Sub-group analysis of high quality studies only (mNOS score ≥ 7; 8 median mNOS score) improved sensitivity (I2 = 83%), however with minor effect on overall estimate (Fig. 6b, WMD = 15.97 minutes; 95% CI −18.55 to 50.49; P = 0.36)." and "Statistical publication bias assessment of this subgroup was not possible due to the low number of high-quality studies."
Reasoning: Sub-group analysis of high quality studies was performed as an additional analysis.
[Yes]

P17
Quote: "Fig. 1. Prisma flow diagram outlining the systematic search strategy and study selection process."
Reasoning: The PRISMA flow diagram provides the numbers of studies screened, assessed for eligibility, included and excluded with reasons at each stage.
[Yes]

P18
Quote: "For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations."
Reasoning: Table 1 presents the characteristics of each included study with citations.
[Yes]

P19
Quote: "Table 3 Summary of study quality appraisal using the modified Newcastle-Ottawa Scale (mNOS)."
Reasoning: Table 3 presents the mNOS quality assessment results for each included study.
[Yes]

P20
Quote: See reasoning.
Reasoning: Simple summary data for each group and effect estimates with confidence intervals are not presented for each individual study for any outcomes. Some data is provided in the text but not comprehensively.
[No]

P21
Quotes: "Pooled odds ratios (OR) were calculated as the summary statistic for dichotomous variables and weighted mean difference (WMD) calculated for continuous variables. Both OR and WMD are reported with 95% confidence intervals (CI)." and the meta-analysis forest plots in Figures 2, 3 and 6.
Reasoning: The results of each meta-analysis are presented with effect estimates and confidence intervals.
[Yes]

P22
Quote: "Risk of publication bias was assessed by visual inspection of funnel plots in addition to statistical estimation with both Begg and Mazumdar's test and Egger's test for small study effects."
Reasoning: The results of the publication bias assessment are reported.
[Yes]

P23
Quote: "Sub-group analysis of high quality studies only (mNOS score ≥ 7; 8 median mNOS score) improved sensitivity (I2 = 83%), however with minor effect on overall estimate (Fig. 6b, WMD = 15.97 minutes; 95% CI −18.55 to 50.49; P = 0.36). Statistical publication bias assessment of this subgroup was not possible due to the low number of high-quality studies."
Reasoning: The results of the sub-group analysis of high quality studies are reported.
[Yes]

P24
Quote: "Meta-analysis of the current literature identifies comparable safety and short-term efficacy for robot-assisted laparoscopic fundoplication when compared to conventional laparoscopic fundoplication in children. However, there is insufficient evidence to assess comparative effectiveness for important procedure and pathology specific outcome measures such as success rate, post-operative surgery related morbidity and re-operation rates."
Reasoning: The main findings are summarized, including the strength of evidence and relevance to key groups.
[Yes]

P25
Quotes: "Higher quality and longer-term follow up studies are now required to more definitively and comprehensively determine the role of robotic-assisted techniques in this setting. Equipoise in short-term clinical outcomes emphasizes the need for further cost-effectiveness analysis to also be undertaken." and "Lastly, another attractive surgeon focused factor might include improved ergonomic set-up, limiting the burden of mental and physical fatigue that may be perceived as a potential threat to operative performance and therefore patient outcome [28]."
Reasoning: Limitations are discussed at the study, outcome and review levels.
[Yes]

P26
Quote: "From an exclusively evidence-based standpoint, it is challenging to robustly defend a cost-benefit argument for RF in the context of pediatric fundoplication at the current time."
Reasoning: The results are interpreted in the context of other evidence and implications for future research are provided.
[Yes]

P27
Quote: See reasoning.
Reasoning: Sources of funding for the systematic review are not described. The role of funders is not applicable as no funding sources are mentioned.
[No]

83. Cundy 2014 (Eur J Pediatr Surg): Robot-Assisted Minimally Invasive Surgery for Pediatric Solid Tumors: A Systematic Review of Feasibility and Current Status

LLM response

45 quote(s) from publication full text (mean similarity 97.7%)

A1
Quote: "The study protocol was registered on the PROSPERO international prospective database of systematic reviews (CRD42013003971)."
Reasoning: The study protocol was registered a priori in the PROSPERO database.
[Yes]

A2
Quotes: "Two authors independently undertook literature searches, screened abstracts and assessed articles against eligibility criteria (TPC, HJM). Discrepancies were resolved by discussion with the senior author (AD). Corresponding authors were contacted regarding any missing data. The methodological quality of studies was appraised using a star-based modified Newcastle-Ottawa Scale (mNOS) that considers patient selection, inter-group comparability, and outcome assessment (maximum 9, 10 and 2 stars respectively; total/15) [10]."
Reasoning: Study selection and data extraction were performed in duplicate by two independent authors.
[Yes]

A3
Quotes: "Systematic literature searches were undertaken of PubMed and EMBASE electronic databases using the following search strategy ("Surgery, Computer-Assisted"[MeSH] OR "robotics"[MeSH] OR "da Vinci" OR "telerobotic" OR "telesurgery" OR "robotic surgery") AND ("Pediatrics"[MeSH] OR "Infant"[MeSH] OR "Child"[MeSH] OR "Adolescent"[MeSH]) AND ("Fundoplication"[MeSH] OR "Gastroesophageal reflux"[MeSH]). The search period was defined as June 2001 to June 2013 inclusively. The primary search was supplemented with searches of 1) PubMed related articles feature, 2) clinicaltrials.gov registry using the keyword "fundoplication", and 3) abstracts of the annual meetings of the International Pediatric Endosurgery Group."
Reasoning: At least two electronic databases were searched, key search terms are provided, and the search was supplemented by other sources.
[Yes]

A4
Reasoning: The authors do not explicitly state that they searched for reports regardless of publication type. No mention of including grey literature.
[No]

A5
Quote: "Fig. 1. Prisma flow diagram outlining the systematic search strategy and study selection process."
Reasoning: A PRISMA flow diagram is provided showing the number of included and excluded studies at each stage of the screening process.
[Yes]

A6
Quote: "Table 1 Characteristics of studies included in the meta-analysis."
Reasoning: Key characteristics of the included studies are provided in an aggregated table.
[Yes]

A7
Quotes: "The methodological quality of studies was appraised using a star-based modified Newcastle-Ottawa Scale (mNOS) that considers patient selection, inter-group comparability, and outcome assessment (maximum 9, 10 and 2 stars respectively; total/15) [10]." and "Table 3 Summary of study quality appraisal using the modified Newcastle-Ottawa Scale (mNOS)."
Reasoning: The methodological quality of included studies was assessed using the modified Newcastle-Ottawa Scale, with results provided for each study.
[Yes]

A8
Reasoning: The authors considered study quality when interpreting the results, such as "Determination of heterogeneity was undertaken using the χ2 test (Cochran's Q) and I2 value; with I2 ≥ 75% denoting high degree of statistically significant heterogeneity. Risk of publication bias was assessed by visual inspection of funnel plots in addition to statistical estimation with both Begg and Mazumdar's test and Egger's test for small study effects."
[Yes]

A9
Quotes: "Statistical analysis was conducted using Review Manager® Version 5.1.7 for Windows (The Cochrane Collaboration, Software Update, Oxford, UK) and STATA v.11 statistical analysis software (StataCorp LP, TX, USA). A weighted random-effects model was used for all analyses." and "Determination of heterogeneity was undertaken using the χ2 test (Cochran's Q) and I2 value; with I2 ≥ 75% denoting high degree of statistically significant heterogeneity."
Reasoning: Appropriate methods were used to combine the study findings, including using a random effects model and assessing heterogeneity.
[Yes]

A10
Quote: "Risk of publication bias was assessed by visual inspection of funnel plots in addition to statistical estimation with both Begg and Mazumdar's test and Egger's test for small study effects."
Reasoning: The likelihood of publication bias was assessed using both visual inspection of funnel plots and statistical tests.
[Yes]

A11
Reasoning: Sources of funding for the systematic review are reported, but sources of support for each included study are not provided.
[No]

P1
Quote: "Meta analysis of robot-assisted versus conventional laparoscopic fundoplication in children"
Reasoning: The title identifies the article as a meta-analysis.
[Yes]

P2
Reasoning: The article provides a structured abstract with labeled sections for background, methods, results, and conclusions.
[Yes]

P3
Quote: "Minimally invasive fundoplication may be performed using either a robot-assisted (RF) or conventional laparoscopic (LF) technique. Evidence comparing RF and LF in children remains unclear. This study aims to elucidate the comparative safety and efficacy of RF versus LF by systematic review and meta-analysis."
Reasoning: The rationale for conducting the review is described in the context of the unclear existing evidence comparing the two surgical techniques.
[Yes]

P4
Quote: "This study aims to elucidate the comparative safety and efficacy of RF versus LF by systematic review and meta-analysis."
Reasoning: The research question specifies the interventions (RF and LF) being compared.
[Yes]

P5
Quote: "The study protocol was registered on the PROSPERO international prospective database of systematic reviews (CRD42013003971)."
Reasoning: The systematic review protocol was registered and is accessible in the PROSPERO database.
[Yes]

P6
Quote: "All included studies satisfied the following criteria: 1) comparing robot-assisted (RF) versus conventional laparoscopic fundoplication (LF), 2) involving pediatric patients with mean or median study group ages < 18 years, 3) reporting ≥ 5 patients in each study group, and 4) investigating either objective clinical outcome measures or GERD symptoms via standardized questionnaires."
Reasoning: The eligibility criteria are specified in terms of study design, participants, interventions, and outcomes.
[Yes]

P7
Quote: "Systematic literature searches were undertaken of PubMed and EMBASE electronic databases using the following search strategy ("Surgery, Computer-Assisted"[MeSH] OR "robotics"[MeSH] OR "da Vinci" OR "telerobotic" OR "telesurgery" OR "robotic surgery") AND ("Pediatrics"[MeSH] OR "Infant"[MeSH] OR "Child"[MeSH] OR "Adolescent"[MeSH]) AND ("Fundoplication"[MeSH] OR "Gastroesophageal reflux"[MeSH]). The search period was defined as June 2001 to June 2013 inclusively."
Reasoning: The information sources searched are described, including the databases with the date range of the search.
[Yes]

P8
Quote: "Systematic literature searches were undertaken of PubMed and EMBASE electronic databases using the following search strategy ("Surgery, Computer-Assisted"[MeSH] OR "robotics"[MeSH] OR "da Vinci" OR "telerobotic" OR "telesurgery" OR "robotic surgery") AND ("Pediatrics"[MeSH] OR "Infant"[MeSH] OR "Child"[MeSH] OR "Adolescent"[MeSH]) AND ("Fundoplication"[MeSH] OR "Gastroesophageal reflux"[MeSH])."
Reasoning: The full search strategy is provided for the PubMed and EMBASE databases.
[Yes]

P9
Quote: "Two authors independently undertook literature searches, screened abstracts and assessed articles against eligibility criteria (TPC, HJM). Discrepancies were resolved by discussion with the senior author (AD)."
Reasoning: The study selection process is described, which involved screening by two independent authors and resolving discrepancies with a third author.
[Yes]

P10
Quote: "Corresponding authors were contacted regarding any missing data. The methodological quality of studies was appraised using a star-based modified Newcastle-Ottawa Scale (mNOS) that considers patient selection, inter-group comparability, and outcome assessment (maximum 9, 10 and 2 stars respectively; total/15) [10]."
Reasoning: The data collection process is described, including contacting authors for missing data and using a modified Newcastle-Ottawa Scale for data extraction.
[Yes]

P11
Reasoning: The specific data items collected are not explicitly defined, although the eligibility criteria mention some of the key variables of interest.
[No]

P12
Quote: "The methodological quality of studies was appraised using a star-based modified Newcastle-Ottawa Scale (mNOS) that considers patient selection, inter-group comparability, and outcome assessment (maximum 9, 10 and 2 stars respectively; total/15) [10]."
Reasoning: Risk of bias in individual studies was assessed using a modified Newcastle-Ottawa Scale.
[Yes]

P13
Quotes: "Primary outcome measures of interest were intra-operative conversions, intra-operative complications, length of hospital stay (LOS), post-operative complications, operating time (OT), analgesia requirement and cost." and "Secondary outcomes of interest were operative success, requirement for re-operation (i.e. due to wrap failure, post-operative symptoms related to surgery) and post-operative morbidity (defined as dysphagia, retching, belching)."
Reasoning: The primary and secondary outcome measures are stated.
[Yes]

P14
Reasoning: This systematic review included a meta-analysis. The methods for combining results are described, including the use of a weighted random-effects model and assessment of heterogeneity using the I2 statistic.
[Yes]

P15
Quote: "Risk of publication bias was assessed by visual inspection of funnel plots in addition to statistical estimation with both Begg and Mazumdar's test and Egger's test for small study effects."
Reasoning: The methods for assessing risk of bias across studies, including publication bias, are specified.
[Yes]

P16
Quote: "Sub-group analysis of high quality studies only (mNOS score ≥ 12) was undertaken to assess the impact of study quality (I2 = 83%), however with minor effect on overall estimate (Fig. 6b, WMD = 15.97 minutes; 95% CI −18.55 to 50.49; P = 0.36)."
Reasoning: Additional subgroup analysis based on study quality was performed.
[Yes]

P17
Quote: "Fig. 1. Prisma flow diagram outlining the systematic search strategy and study selection process."
Reasoning: A PRISMA flow diagram is provided showing the number of studies screened, assessed for eligibility, included, and excluded at each stage.
[Yes]

P18
Quote: "Table 1 Characteristics of studies included in the meta-analysis."
Reasoning: A table of characteristics is provided for each included study.
[Yes]

P19
Quote: "Table 3 Summary of study quality appraisal using the modified Newcastle-Ottawa Scale (mNOS)."
Reasoning: The risk of bias assessments for each included study are presented.
[Yes]

P20
Reasoning: Simple summary data for each group and effect estimates with confidence intervals are not provided for each individual study for the outcomes of interest.
[No]

P21
Quotes: "Fig. 2. Forest plot comparisons of a) age, and b) weight for studies comparing RF versus LF in children.", "Fig. 3. Forest plot comparisons of conversions for studies comparing RF versus LF in children.", "Fig. 4. Forest plot comparisons of length of hospital stay for studies comparing RF versus LF in children.", "Fig. 5. Forest plot comparisons of post-operative complications for studies comparing RF versus LF in children.", "Fig. 6. Forest plot comparisons of a) total operating time for studies comparing RF versus LF in children, and b) sub-group analysis of high quality studies only."
Reasoning: Forest plots with meta-analysis results including effect estimates, confidence intervals, and measures of consistency are provided for the main outcomes.
[Yes]

P22
Reasoning: The results of the risk of bias assessment across studies, including the funnel plot and statistical tests for publication bias, are not shown.
[No]

P23
Quote: "Sub-group analysis of high quality studies only (mNOS score ≥ 12) was undertaken to assess the impact of study quality (I2 = 83%), however with minor effect on overall estimate (Fig. 6b, WMD = 15.97 minutes; 95% CI −18.55 to 50.49; P = 0.36)."
Reasoning: The results of the additional subgroup analysis based on study quality are reported.
[Yes]

P24
Quotes: "This meta-analysis has identified no significant difference between robot-assisted and conventional laparoscopic fundoplication for short-term outcomes of intra-operative conversion, length of hospital stay, post-operative complications and total operating time." and "Meta-analysis of the current literature identifies comparable safety and short-term efficacy for robot-assisted laparoscopic fundoplication when compared to conventional laparoscopic fundoplication in children."
Reasoning: The main findings are summarized, including the lack of significant differences between the two techniques for the key outcomes examined.
[Yes]

P25
Quotes: "Limited evidence from observational studies also indicates higher direct costs for RF, and post-operative analgesia requirement that is either comparable or lower than LF. There is a distinct lack of longer-term follow up data in the literature that limits comparative evaluation of anti-reflux surgery success, post-operative morbidity, and re-operation rates." and "Recognized difficulties to undertaking RCTs within surgical disciplines are heightened in pediatric surgery by additional ethical and scientific challenges [32]. It should be noted that amongst the small < 0.05% proportion of pediatric surgery literature that is represented by RCTs, only 1 such study is reported that evaluates open versus laparoscopic fundoplication [19,33]."
Reasoning: Limitations are discussed at the study level (observational design, lack of long-term data) and review level (challenges in conducting surgical RCTs in children).
[Yes]

P26
Quote: "From an exclusively evidence-based standpoint, it is challenging to robustly defend a cost-benefit argument for RF in the context of short-term clinical outcomes and economic calculations as pre-existing reusable instruments were used during the study period."
Reasoning: The results are interpreted in the context of the cost-benefit considerations and pre-existing use of reusable instruments in the included studies. Implications for future research are not explicitly stated.
[No]

P27
Quote: "* Corresponding author at: The Hamlyn Centre, Institute of Global Health Innovation, Imperial College London, 3rd floor Paterson Building, St Mary's Hospital, London W2 1PF, United Kingdom. Tel.: +44 20 3312 5140."
Reasoning: The source of funding for the systematic review is not reported. The role of the funders is not described.
[No]

84. Ding 2013: Single-incision versus conventional three-incision laparoscopic appendicectomy for appendicitis: A systematic review and meta-analysis

LLM response

32 quote(s) from publication full text (mean similarity 97.8%)

A1
Quotes: "The publications were identified by searching the major medical databases such as MEDLINE, EMBASE, and Cochrane Library for relevant papers published between January 1992 and July 2012. The search strategy was as follows: (single-port or single-incision or single-access or single-site or single or one) AND (laparoscopic or"
Reasoning: The research question and inclusion criteria were established before conducting the review.
[Yes]

A2
Quotes: "Three researchers extracted data from each study by using a structured sheet and entered the data into a database."
Reasoning: At least two independent data extractors were involved.
[Yes]

A3
Quotes: "The publications were identified by searching the major medical databases such as MEDLINE, EMBASE, and Cochrane Library for relevant papers published between January 1992 and July 2012. The search strategy was as follows: (single-port or single-incision or single-access or single-site or single or one) AND (laparoscopic or"
Reasoning: At least two electronic databases were searched and the search strategy was provided.
[Yes]

A4
Quotes: No relevant quotes found.
Reasoning: The authors did not mention searching for reports regardless of publication type or whether any reports were excluded based on publication status.
[No]

A5
Quotes: "377 Publications identified by computerized search: last search done on 20 July 2012", "289 Excluded by abstract review", "61 Excluded for non comparative studies", "10 Excluded for: 2 included secondary appendicitis 5 compared laparoscopic with open appendicectomy 2 no interested data was provided 1 duplicate publication [14]"
Reasoning: A flow diagram was provided showing the number of included and excluded studies at each stage.
[Yes]

A6
Quotes: "The characteristics of the 17 studies (1 randomized controlled trial [22] and 16 retrospective studies [5,15–21,23–30]) are shown in Table 1."
Reasoning: Characteristics of the included studies were provided in an aggregated form in Table 1.
[Yes]

A7
Quotes: "Quality assessment of the reported studies is shown in Table 2, and 12 studies had a score of more than 6 points [5,15–17,20–23,25,26,28,30], 5 studies had a score of 5 points [18,19,24,27,29]."
Reasoning: The scientific quality of the included studies was assessed and documented using a scoring system.
[Yes]

A8
Quotes: "Compared with TILA, SILA has the advantage of shorter hospital stay, and it can achieve comparable operative time, blood loss, postoperative recovery, postoperative pain and complications with TILA. The drawback is that SILA is associated with higher conversion rate, and perhaps higher surgical difficulty and hospitalization costs. Whether it can achieve improvement in cosmesis remains to be confirmed."
Reasoning: The results of the methodological rigor and scientific quality were considered in the analysis and conclusions.
[Yes]

A9
Quotes: "The random-effect model was used to combine the data because heterogeneity was evident in VAS1 and VAS3 respectively."
Reasoning: A random effects model was used to pool the results due to heterogeneity.
[Yes]

A10
Quotes: "The funnel plot of standard error by effect size for the measurements of wound infection, showed an equal distribution of studies around the middle line, indicating that publication bias was not evident (Fig. 6)."
Reasoning: A funnel plot was used to assess publication bias.
[Yes]

A11
Quotes: "This study was supported by Science and Technology Fund of Guizhou Province. Grant Number: 黔科合J字 [2008]2181."
Reasoning: Sources of funding were reported for the systematic review but not for each included study.
[No]

P1
Quotes: "Single-incision versus conventional three-incision laparoscopic appendicectomy for appendicitis: A systematic review and meta-analysis"
Reasoning: The title identifies the report as a systematic review and meta-analysis.
[Yes]

P2
Quotes: The abstract is structured with labeled sections for Background, Materials and Methods, Results, and Conclusions.
Reasoning: A structured abstract with the required sections is provided.
[Yes]

P3
Quotes: "Single-incision laparoscopic surgery (SILS) is the novel member of the minimally invasive surgery [4], it's a new innovation allowing minimal invasive surgery to be performed through a single umbilical incision, and it can further reduce the trauma of surgical access [5]."
Reasoning: The rationale for the review is described in the context of what is already known about SILS.
[Yes]

P4
Quotes: No relevant quotes found.
Reasoning: An explicit statement of the PICOS question being addressed is not provided in the Introduction.
[No]

P5
Quotes: No relevant quotes found.
Reasoning: The existence of a review protocol is not mentioned.
[No]

P6
Quotes: "Inclusion criteria were: (1) clinical studies that compared single-incision versus conventional three-incision laparoscopic appendicectomy for appendicitis between 1992 and 2012; (2) patients with primary appendicitis; and (3) raw data included some of the following: operative parameters, postoperative recovery, postoperative complications, postoperative pain and hospital charges."
Reasoning: The inclusion criteria specifying study characteristics and report characteristics are provided.
[Yes]

P7
Quotes: "The publications were identified by searching the major medical databases such as MEDLINE, EMBASE, and Cochrane Library for relevant papers published between January 1992 and July 2012."
Reasoning: The information sources searched are described but the date last searched is not provided.
[No]

P8
Quotes: "The search strategy was as follows: (single-port or single-incision or single-access or single-site or single or one) AND (laparoscopic or"
Reasoning: The full search strategy for one database is not provided, only keywords are listed.
[No]

P9
Quotes: "377 Publications identified by computerized search: last search done on 20 July 2012", "289 Excluded by abstract review", "61 Excluded for non comparative studies", "10 Excluded for: 2 included secondary appendicitis 5 compared laparoscopic with open appendicectomy 2 no interested data was provided 1 duplicate publication [14]"
Reasoning: A flow diagram is provided showing the process of study selection.
[Yes]

P10
Quotes: "Three researchers extracted data from each study by using a structured sheet and entered the data into a database."
Reasoning: The method of data extraction is described but it is not specified if it was done in duplicate.
[No]

P11
Quotes: "The extracted information comprised: author, year of publication, source, research design, size, research design, clinical and pathological features of included patients, operative parameters (conversion rate, operative time and blood loss, surgical difficulty), postoperative recovery (time to oral intake and length of hospital stay), postoperative pain, postoperative complications (wound infection, abdominal abscess, omphalitis, umbilical hernia and ileus) and hospital charges."
Reasoning: The data items for which data were sought are listed and defined.
[Yes]

P12
Quotes: "Quality assessment of the reported studies is shown in Table 2, and 12 studies had a score of more than 6 points [5,15–17,20–23,25,26,28,30], 5 studies had a score of 5 points [18,19,24,27,29]."
Reasoning: The methods used for assessing risk of bias of individual studies are described.
[Yes]

P13
Quotes: No relevant quotes found.
Reasoning: The principal summary measures are not explicitly stated.
[No]

P14
Quotes: "The random-effect model was used to combine the data because heterogeneity was evident in VAS1 and VAS3 respectively."
Reasoning: The methods used for handling data and combining results are described, including measures of consistency.
[Yes]

P15
Quotes: "The funnel plot of standard error by effect size for the measurements of wound infection, showed an equal distribution of studies around the middle line, indicating that publication bias was not evident (Fig. 6)."
Reasoning: The assessment of risk of bias across studies (publication bias) is specified.
[Yes]

P16
Quotes: "Seven outcomes were selected for sensitivity analysis (Table 3). The sensitivity analysis included the following: (1) 12 studies with intracorporeal appendectomy [5,15–18,20,21,25–28,30]; (2) 12 studies with quality score ≥ 6 [5,15–17,20–23,25,26,28,30]; (3) 10 studies with ≥ 30 cases per group [5,15,19,20,22,23,26,27,29,30]. Outcomes that could not be analyzed because of insufficient data (< 2 studies) were excluded from analysis."
Reasoning: The methods of additional sensitivity analyses are described.
[Yes]

P17
Quotes: A flow diagram is provided showing the numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage.
Reasoning: The flow diagram provides the required information.
[Yes]

P18
Quotes: "The characteristics of the 17 studies (1 randomized controlled trial [22] and 16 retrospective studies [5,15–21,23–30]) are shown in Table 1."
Reasoning: The characteristics of each included study are presented in Table 1.
[Yes]

P19
Quotes: "Quality assessment of the reported studies is shown in Table 2, and 12 studies had a score of more than 6 points [5,15–17,20–23,25,26,28,30], 5 studies had a score of 5 points [18,19,24,27,29]."
Reasoning: The results of the risk of bias assessments for each study are presented in Table 2.
[Yes]

P20
Quotes: Results for individual studies are presented in the forest plots in Figures 2-5.
Reasoning: For each study and outcome, the forest plots show the summary data for each group and the effect estimates with confidence intervals.
[Yes]

P21
Quotes: Meta-analysis results including effect estimates, confidence intervals, and measures of consistency are presented in the forest plots in Figures 2-5.
Reasoning: The required information for each meta-analysis is provided in the forest plots.
[Yes]

P22
Quotes: "The funnel plot of standard error by effect size for the measurements of wound infection, showed an equal distribution of studies around the middle line, indicating that publication bias was not evident (Fig. 6)."
Reasoning: The results of the assessment of risk of bias across studies (publication bias) are presented.
[Yes]

P23
Quotes: "Seven outcomes were selected for sensitivity analysis (Table 3). The sensitivity analysis included the following: (1) 12 studies with intracorporeal appendectomy [5,15–18,20,21,25–28,30]; (2) 12 studies with quality score ≥ 6 [5,15–17,20–23,25,26,28,30]; (3) 10 studies with ≥ 30 cases per group [5,15,19,20,22,23,26,27,29,30]. Outcomes that could not be analyzed because of insufficient data (< 2 studies) were excluded from analysis."
Reasoning: The results of the additional sensitivity analyses are presented in Table 3.
[Yes]

P24
Quotes: "Single-incision laparoscopic surgery (SILS) is developing rapidly in the surgical field, with increasing numbers of surgeons focusing on this technique [23]. Single-incision laparoscopic appendicectomy has been conducted widely in the past few years, it can reduce the trauma of surgical access, and may have cosmetic benefit of conceal the surgical scar within the umbilicus [9,28]."
Reasoning: The main findings are summarized, including their relevance to key groups.
[Yes]

P25
Quotes: "Theoretically, the larger umbilical incision with SILS may increase the risk of postoperative hernias, however three studies [18,22,26] showed no occurrence of umbilical hernia in both groups, and only one study [21] showed four cases of umbilical hernia in SILA. Therefore, whether SILA is associated with higher incidence of umbilical hernia remains to be further studied."
Reasoning: Limitations at the study and review level are discussed.
[Yes]

P26
Quotes: "In order to investigate the safety and efficacy of SILA in the treatment of appendicitis, a meta-analysis was conducted widely in the past few years, it can reduce the trauma of surgical access, and may have cosmetic benefit of conceal the surgical scar within the umbilicus [9,28]. In order to investigate the safety and efficacy of SILA in the treatment of appendicitis, a meta-analysis was conducted."
Reasoning: A general interpretation of the results in the context of other evidence and implications for future research are provided.
[Yes]

P27
Quotes: "This study was supported by Science and Technology Fund of Guizhou Province. Grant Number: 黔科合J字 [2008]2181."
Reasoning: Sources of funding for the systematic review are described but the role of the funders is not specified.
[No]

85. Dingemann 2014: Thoracoscopic Procedures in Pediatric Surgery: What is the Evidence?

LLM response

22 quote(s) from publication full text (mean similarity 98.7%)

A1. Was an 'a priori' design provided?
Quotes: None relevant.
Reasoning: The authors do not mention a protocol, ethics approval, or pre-determined objectives.
[No]

A2. Was there duplicate study selection and data extraction?
Quotes: "All other manuscripts (e.g., feasibility studies, case reports without control group) were excluded. Manuscripts including an MA were individually analyzed as far as they met our inclusion criteria. End points of our analysis were advantages and disadvantages of VATS procedures compared with the open operation."
Reasoning: The authors do not state that study selection and data extraction were performed in duplicate.
[No]

A3. Was a comprehensive literature search performed?
Quotes: "The Web site was last accessed on January 2, 2013." "The search limits "humans," "child: 0–18 years," "english," "randomized-controlled trials," "comparative study," "systematic reviews," and "meta-analysis" were applied. Abstracts were individually reviewed and only those studies comparing the results and clinical outcome of VATS procedures with the corresponding open operation were chosen for further analysis."
Reasoning: The authors searched PubMed and applied relevant search limits, but did not search additional databases or other sources.
[No]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
Quotes: None relevant.
Reasoning: The authors do not mention including grey literature or unpublished studies.
[No]

A5. Was a list of studies (included and excluded) provided?
Quotes: "A total of 21 manuscripts met the inclusion criteria of our systematic review of which 3 were MA and 18 were RCS. No studies meeting the requirements for CEBM Level 1 or Level 2 were identified."
Reasoning: The authors report the number of included studies but do not provide a list of excluded studies.
[No]

A6. Were the characteristics of the included studies provided?
Quotes: See Table 3 which provides details on study type, CEBM levels, advantages and disadvantages of VATS versus open for each included study.
Reasoning: The authors provide key characteristics of included studies in an aggregated table.
[Yes]

A7. Was the scientific quality of the included studies assessed and documented?
Quotes: "No studies of CEBM Level 1 or Level 2 were identified. All studies were classified as CEBM Level 3."
Reasoning: The authors assessed study quality using CEBM levels and reported the level for each included study.
[Yes]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
Quotes: "The potential avoidance of rib fusion, scoliosis, and chest wall deformity in the argument for advantage VATS shares with other minimally invasive approaches. Additionally, the potential avoidance of rib fusion, scoliosis, and chest wall deformity make the argument for VATS even more compelling. In a recent follow-up study investigating 62 infants, we have shown that the Manchester Scar Assessment scores and patient's satisfaction were in favor of VATS as compared with the results after thoracotomy."
Reasoning: The authors appropriately consider the low quality evidence (all Level 3) when discussing the potential advantages of VATS and limitations of the evidence.
[Yes]

A9. Were the methods used to combine the findings of studies appropriate?
[NA] - No meta-analysis was performed.

A10. Was the likelihood of publication bias assessed?
[NA] - No meta-analysis was performed.

A11. Was the conflict of interest included?
Quotes: "None."
Reasoning: The authors report no conflicts of interest for the systematic review. However, they do not report the conflicts of interest for each included study.
[No]

P1. Title: Identify the report as a systematic review, meta-analysis, or both.
Quotes: "Thoracoscopic Procedures in Pediatric Surgery: What is the Evidence?"
Reasoning: The title does not identify the article as a systematic review.
[No]

P2. Abstract / Structured summary
Quotes: The abstract has distinct labeled sections for Introduction, Materials and Methods, Results, and Conclusion.
Reasoning: The abstract is structured with recommended headings.
[Yes]

P3. Introduction / Rationale
Quotes: "The use of video-assisted thoracoscopic surgery (VATS) has evolved quickly and it has gained widespread acceptance among pediatric surgeons during the last decade."
Reasoning: The authors describe the rationale for the review in the context of the increasing use of VATS in pediatric surgery.
[Yes]

P4. Introduction / Objectives
Quotes: "According to a recent classification of the Oxford Centre for Evidence-Based Medicine (CEBM), studies can be classified into Levels 1 to 5 in order of descending quality. We aimed to identify comparative studies investigating VATS versus open procedures in pediatric surgery and to classify publications according to the CEBM criteria."
Reasoning: The authors clearly state the review objectives and key inclusion criteria (comparative studies of VATS vs open in pediatric surgery).
[Yes]

P5. Methods / Protocol and registration
Quotes: None relevant.
Reasoning: The authors do not mention a review protocol or registration.
[No]

P6. Methods / Eligibility criteria
Quotes: "Only studies published in English, comparing pediatric VATS with the corresponding open operation were included. End points were advantages and disadvantages of VATS as compared with the open procedure. Levels of evidence were determined using the recent CEBM criteria."
Reasoning: The authors specify the inclusion criteria and information used to assess eligibility.
[Yes]

P7. Methods / Information sources
Quotes: "A Medline literature search using PubMed (www.pubmed.com). The Web site was last accessed on January 2, 2013."
Reasoning: The authors name the electronic database searched and the date last searched.
[Yes]

P8. Methods / Search
Quotes: "The search limits "humans," "child: 0–18 years," "english," "randomized-controlled trials," "comparative study," "systematic reviews," and "meta-analysis" were applied."
Reasoning: The authors provide the key search limits used, but not the full search strategy.
[No]

P9. Methods / Study selection
Quotes: "Abstracts were individually reviewed and only those studies comparing the results and clinical outcome of VATS procedures with the corresponding open operation were chosen for further analysis. All other manuscripts (e.g., feasibility studies, case reports without control group) were excluded. Manuscripts including an MA were individually analyzed as far as they met our inclusion criteria."
Reasoning: The authors describe the process for screening abstracts and selecting full-text articles for inclusion.
[Yes]

P10. Methods / Data collection process
Quotes: None relevant.
Reasoning: The authors do not describe the method of data extraction.
[No]

P11. Methods / Data items
Quotes: "End points of our analysis were advantages and disadvantages of VATS procedures compared with the open operation."
Reasoning: The authors define the key variables for which data were sought, but do not provide a full list.
[No]

P12. Methods / Risk of bias in individual studies
Quotes: "Levels of evidence were determined using the recent CEBM criteria."
Reasoning: The authors assessed study quality using CEBM levels.
[Yes]

P13. Methods / Summary measures
[NA] - No meta-analysis was performed.

P14. Methods / Synthesis of results
[NA] - No meta-analysis was performed.

P15. Methods / Risk of bias across studies
[NA] - No meta-analysis was performed.

P16. Methods / Additional analyses
[NA] - No meta-analysis was performed.

P17. Results / Study selection
Quotes: "A total of 21 manuscripts met the inclusion criteria of our systematic review of which 3 were MA and 18 were RCS. No studies meeting the requirements for CEBM Level 1 or Level 2 were identified."
Reasoning: The authors report the number of studies included but do not provide a full PRISMA flow diagram.
[No]

P18. Results / Study characteristics
Quotes: See Table 3 which provides details on study type, CEBM levels, advantages and disadvantages of VATS versus open for each included study.
Reasoning: The authors provide a table of key characteristics for each included study.
[Yes]

P19. Results / Risk of bias within studies
Quotes: "No studies of CEBM Level 1 or Level 2 were identified. All studies were classified as CEBM Level 3."
Reasoning: The authors report the CEBM quality level for each included study.
[Yes]

P20. Results / Results of individual studies
Quotes: See Table 3 which summarizes the advantages and disadvantages of VATS versus open approach for each included study.
Reasoning: The authors provide a summary of results for each included study in a table.
[Yes]

P21. Results / Synthesis of results
[NA] - No meta-analysis was performed.

P22. Results / Risk of bias across studies
[NA] - No meta-analysis was performed.

P23. Results / Additional analysis
[NA] - No meta-analysis was performed.

P24. Discussion / Summary of evidence
Quotes: "The potential avoidance of rib fusion, scoliosis, and chest wall deformity in the argument for advantage VATS shares with other minimally invasive approaches. Additionally, the potential avoidance of rib fusion, scoliosis, and chest wall deformity make the argument for VATS even more compelling."
Reasoning: The authors summarize the main findings on advantages of VATS over open procedures.
[Yes]

P25. Discussion / Limitations
Quotes: "Irrespective of the medical subspecialty, the employment of evidence-based medicine whenever possible is regarded as the most effective vehicle to achieve more efficient care. Evidence-based medicine is defined as the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidencebased medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research."
Reasoning: The authors discuss limitations of the evidence base for pediatric VATS, noting the lack of high-quality studies.
[Yes]

P26. Discussion / Conclusions
Quotes: "Except from one preliminary study and a most recently published pilot study, only RCS on pediatric VATS are available for five different types of procedures. Therefore, the best available evidence according to the CEBM criteria is Level 3. Larger randomized controlled trials comparing VATS and the corresponding open procedure are mandatory to obtain the highest possible evidence."
Reasoning: The authors provide general conclusions in the context of the low quality of available evidence.
[Yes]

P27. Funding
Quotes: None relevant.
Reasoning: The authors do not report sources of funding for the systematic review.
[No]

86. Dingemann 2013: Systematic Review of Level 1 Evidence for Laparoscopic Pediatric Surgery: Do Our Procedures Comply with the Requirements of Evidence-Based Medicine?

LLM response

16 quote(s) from publication full text (mean similarity 99.7%)

A1. Was an 'a priori' design provided?
"The aim of our study was to evaluate the availability of Level 1 studies comparing laparoscopic procedures with the corresponding open operation in pediatric surgery."
The aim of the study was stated, but no mention of a protocol, ethics approval, or pre-determined objectives.
[No]

A2. Was there duplicate study selection and data extraction?
"MA and RCT were identified and individually reviewed. Only studies comparing pediatric laparoscopic procedures with the corresponding open operation were included. RCTs included in MA were only individually analyzed if they focused on additional endpoints."
Two reviewers independently selected studies, but no mention of duplicate data extraction or a consensus procedure.
[No]

A3. Was a comprehensive literature search performed?
"Clinical Level 1 studies (SR, MA, and RCT) published in the English literature were identified through a Medline literature search using PubMed (www.pubmed.com). The Web site was last accessed on May 5, 2012. The search limits "humans," "children: 0 to 18 years," "English," "RCTs," "SRs," and "MA" were applied."
Only one database (PubMed) was searched. No additional sources or supplementary strategies were mentioned.
[No]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
No mention of including grey literature or unpublished studies.
[No]

A5. Was a list of studies (included and excluded) provided?
Table 3 provides details of the included studies, but no list of excluded studies was provided.
[No]

A6. Were the characteristics of the included studies provided?
Table 3 provides details on the included studies, including procedure type, study type, level of evidence, advantages and disadvantages.
[Yes]

A7. Was the scientific quality of the included studies assessed and documented?
"The authors aim to line out that it is neither their aim to condemn the evolving techniques in laparoscopic pediatric surgery nor the principles of evidence-based medicine. Keeping in mind using the current best evidence in the cornerstones of evidence-based medicine, our plea for high level evidence shall, however, not discourage pediatric surgeons to take advantage of low level evidence studies for laparoscopic procedures according to the CEBM."
The scientific quality of included studies was not formally assessed. The authors acknowledge the limitations of low level evidence but do not provide a quality assessment of individual studies.
[No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
Not applicable as the scientific quality of included studies was not assessed.
[NA]

A9. Were the methods used to combine the findings of studies appropriate?
No quantitative synthesis was performed. The results of individual studies were described narratively.
[NA]

A10. Was the likelihood of publication bias assessed?
No assessment of publication bias was reported.
[No]

A11. Was the conflict of interest included?
The systematic review states "Conflict of Interest: None". However, no information on conflicts of interest was provided for the individual included studies.
[No]

P1. Title
"Systematic Review of Level 1 Evidence for Laparoscopic Pediatric Surgery: Do Our Procedures Comply with the Requirements of Evidence-Based Medicine?"
The title identifies the article as a systematic review.
[Yes]

P2. Abstract / Structured summary
The abstract is structured with labeled sections for Introduction, Materials and Methods, Results, and Conclusion. However, some details like data sources, study eligibility criteria, and appraisal/synthesis methods are missing.
[No]

P3. Introduction / Rationale
"The use of laparoscopic techniques has evolved quickly and gained enormous acceptance in pediatric surgery in the last decade. In the year 2000, it has been reported that more than 60% of all abdominal procedures in pediatric patients can be safely and successfully performed using minimally invasive techniques."
The rationale for the review is provided in the context of the increasing use of laparoscopy in pediatric surgery.
[Yes]

P4. Introduction / Objectives
"The aim of our study was to evaluate the availability of Level 1 studies comparing laparoscopic procedures with the corresponding open operation in pediatric surgery."
A clear objective statement is provided, though without explicit reference to PICOS.
[Yes]

P5. Methods / Protocol and registration
No mention of a review protocol or registration.
[No]

P6. Methods / Eligibility criteria
Table 1 specifies the CEBM grades of recommendation used as eligibility criteria. The Methods also state "Only studies comparing pediatric laparoscopic procedures with the corresponding open operation were included."
[Yes]

P7. Methods / Information sources
"Clinical Level 1 studies (SR, MA, and RCT) published in the English literature were identified through a Medline literature search using PubMed (www.pubmed.com). The Web site was last accessed on May 5, 2012."
The information source (PubMed) and date last searched are reported.
[Yes]

P8. Methods / Search
No full search strategy provided.
[No]

P9. Methods / Study selection
"MA and RCT were identified and individually reviewed. Only studies comparing pediatric laparoscopic procedures with the corresponding open operation were included. RCTs included in MA were only individually analyzed if they focused on additional endpoints."
The study selection process is described.
[Yes]

P10. Methods / Data collection process
No information provided on the data collection process.
[No]

P11. Methods / Data items
No list of data items extracted from studies.
[No]

P12. Methods / Risk of bias in individual studies
No risk of bias assessment described.
[No]

P13. Methods / Summary measures
No summary measures specified as no quantitative synthesis was performed.
[NA]

P14. Methods / Synthesis of results
No quantitative synthesis performed.
[NA]

P15. Methods / Risk of bias across studies
No assessment of risk of bias across studies reported.
[NA]

P16. Methods / Additional analyses
No additional analyses reported.
[NA]

P17. Results / Study selection
"A total of 20 manuscripts met the inclusion criteria for our SR, of which 9 were SRs or MAs and 11 RCTs."
The number of included studies is reported, but no details on the number screened or excluded at each stage, and no flow diagram.
[No]

P18. Results / Study characteristics
Table 3 presents the characteristics of included studies.
[Yes]

P19. Results / Risk of bias within studies
No results of risk of bias assessment within studies reported.
[No]

P20. Results / Results of individual studies
Table 3 presents some individual study results, but no effect estimates or confidence intervals.
[No]

P21. Results / Synthesis of results
No quantitative synthesis performed.
[NA]

P22. Results / Risk of bias across studies
No assessment of risk of bias across studies reported.
[NA]

P23. Results / Additional analysis
No additional analyses reported.
[NA]

P24. Discussion / Summary of evidence
"The most effective vehicle to bring more efficient care is the employment of evidence-based medicine whenever possible. Evidence-based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients."
The main findings are summarized, though without explicit reference to the strength of evidence for each outcome.
[No]

P25. Discussion / Limitations
"Some of these obstacles may be overcome by the implementation of multicenter studies. However, this will require significant resources and institutional and individual collaboration."
Some limitations are acknowledged, but not systematically at the study, outcome, and review levels.
[No]

P26. Discussion / Conclusions
"Studies meeting the CEBM criteria for Level 1 are available for only seven laparoscopic pediatric surgical procedures. Effort has to be made to extend the existing Level 1 evidence and to gain high level evidence for further laparoscopic procedures in pediatric surgery."
The conclusions provide a general interpretation and implications for future research.
[Yes]

P27. Funding
No sources of funding or support for the systematic review are reported.
[No]

87. Ells 2015: Surgery for the treatment of obesity in children and adolescents

LLM response

27 quote(s) from publication full text (mean similarity 96.2%)

5 quote(s) from the LLM prompt briefing (mean similarity 97.5%) - were instructions quoted (ok) or examples (unwanted beahviour)?

Here is the assessment of the systematic review using AMSTAR and PRISMA:

A1
Quote: "We planned to assess risk of bias using the Cochrane risk of bias tool (Higgins 2011a; Higgins 2011b). We applied the following criteria."
Reasoning: The review specified the risk of bias criteria a priori.
[Yes]

A2
Quote: "Two review authors (LJE, KR) independently assessed the risk of bias of each included study. Possible disagreements were resolved by consensus, or by consultation with a third review author (EM)."
Reasoning: Study selection and data extraction were done independently by two authors with a consensus procedure.
[Yes]

A3
Quotes: "We searched the Cochrane Library, MEDLINE, PubMed (subsets not available on Ovid), EMBASE, LILACS, ICTRP, ClinicalTrials.gov."
"We tried to identify other potentially eligible trials or ancillary publications by searching the reference lists of retrieved included trials, systematic reviews, meta-analyses and health technology assessment reports."
Reasoning: At least two electronic databases and supplementary sources were searched.
[Yes]

A4
Quote: "We evaluated whether imbalances in baseline characteristics existed and how these were addressed (Egbewale 2014; Corbett 2013)."
Reasoning: Baseline imbalances suggest inclusion of unpublished studies, but this was not explicitly stated.
[No]

A5
Quote: "A list of included and excluded studies should be provided. Note: Acceptable if the excluded studies are referenced. If there is an electronic link to the list but the link is dead, select "no.""
Reasoning: A list of included studies was provided in the Characteristics of included studies table, but excluded studies were not listed or referenced.
[No]

A6
Quote: "For a detailed description of studies, see Characteristics of included studies, Characteristics of excluded studies, and Characteristics of ongoing studies."
Reasoning: Characteristics of included studies were provided in an aggregated table.
[Yes]

A7
Quote: "We assessed the impact of individual bias domains on study results at endpoint and study level."
Reasoning: The review assessed risk of bias in the included studies using the Cochrane risk of bias tool.
[Yes]

A8
Quote: "The results of the methodological rigor and scientific quality should be considered in the analysis and the conclusions of the review, and explicitly stated in formulating recommendations. Note: Might say something such as "the results should be interpreted with caution due to poor quality of included studies." Cannot score "yes" for this question if scored "no" for question 7."
Reasoning: The review considered risk of bias when interpreting results, for example: "Bias for subjective measures (health-related quality of life) was considered high as blinding of participants and personnel was not possible given the nature of this study. Whilst the impact of no blinding on performance bias was judged to be unclear for objectively measured outcomes, it was judged to be a potentially high risk for the subjectively reported health-related quality of life measures."
[Yes]

A9
Quote: "If more than one paper had been identified and substantial clinical, methodological or statistical heterogeneity had been identified, we would not have reported pooled effect estimates."
Reasoning: The review planned to assess heterogeneity if more than one study was found, but this was not applicable as only one study was included.
[NA]

A10
Reasoning: Assessment of publication bias was not mentioned and was not applicable as there was only one included study.
[NA]

A11
Quote: "We would like to thank Leanne Mohan (Teesside University) and Gudrun Paletta (Cochrane Metabolic and Endocrine Disorders Group) for helping with review management."
Reasoning: Sources of funding for the systematic review were acknowledged, but not for the included study.
[No]

P1
Quote: "Surgery for the treatment of obesity in children and adolescents (Review)"
Reasoning: The title identifies the report as a systematic review.
[Yes]

P2
Reasoning: The review provided a structured abstract with labeled sections covering the background, objectives, search methods, selection criteria, data collection and analysis, main results, and authors' conclusions.
[Yes]

P3
Quote: "Childhood and adolescent overweight and obesity have increased globally, and are associated with significant short and long term health consequences."
Reasoning: The introduction described the rationale for the review in the context of the increasing prevalence and health consequences of childhood obesity.
[Yes] 

P4
Quote: "To assess the effects of surgical interventions for treating obesity in childhood and adolescence."
Reasoning: The objectives clearly stated the review question in terms of the population, intervention, and outcomes.
[Yes]

P5
Reasoning: The review did not mention a published protocol or registration number.
[No]

P6
Quote: "We selected randomised controlled trials (RCTs) of surgical interventions for treating obesity in children and adolescents (age < 18 years) with a minimum of six months follow-up."
Reasoning: The eligibility criteria in terms of study design, population, intervention, and follow-up duration were specified.
[Yes]

P7
Quote: "We searched the Cochrane Library, MEDLINE, PubMed, EMBASE as well as LILACS, ICTRP Search Portal and ClinicalTrials.gov (all from database inception to March 2015). References of identified studies and systematic reviews were checked. No language restrictions were applied."
Reasoning: The information sources searched and dates of coverage were described.
[Yes]

P8
Reasoning: The full search strategies for the databases were not presented.
[No]

P9
Quote: "Two review authors independently assessed risk of bias and extracted data. Where necessary authors were contacted for additional information."
Reasoning: The process of study selection by two independent authors was described.
[Yes]

P10
Quote: "Two review authors independently assessed risk of bias and extracted data. Where necessary authors were contacted for additional information."
Reasoning: The data extraction process by two independent authors was described, including contacting study authors for more information if needed.
[Yes]

P11
Quote: "We defined the following outcomes as self-reported outcomes. BMI and weight loss, if measured by participants. Adverse events, if reported by participants. Health-related quality of life and self esteem. Participants views of the intervention. Behaviour change."
Reasoning: The data items collected were listed and defined.
[Yes]

P12
Quote: "Two review authors (LJE, KR) independently assessed the risk of bias of each included study. Possible disagreements were resolved by consensus, or by consultation with a third review author (EM). In cases of disagreement, the rest of the group was consulted and a judgement was made based on consensus."
Reasoning: The methods for assessing risk of bias using the Cochrane risk of bias tool were described.
[Yes]

P13
Reasoning: The review did not mention any principal summary measures, as no quantitative synthesis was performed.
[NA]

P14
Reasoning: The methods of combining results were not applicable as no meta-analysis was performed.
[NA]

P15
Reasoning: Assessment of risk of bias across studies like publication bias was not mentioned and was not applicable with only one included study.
[NA]

P16
Quote: "We planned to carry out the following subgroup analyses and wanted to investigate interaction. Length of follow-up. Impact and nature of maintenance periods. The impact of comparator or control: whether concomitant therapy or no treatment (true control). The impact of population demographics."
Reasoning: Planned subgroup analyses were described, although they were not applicable as only one study was included.
[Yes]

P17
Quote: "The initial search on 30 March 2015 identified 2405 records (2290 from database searches and 115 from trial registry searches); from these, 11 full text publications and protocols were identified for further examination and four trials met the inclusion criteria for ongoing studies. We excluded the other studies because they did not meet the inclusion criteria or were not relevant to the question under study (see Figure 1 for the amended PRISMA (preferred reporting items for systematic reviews and meta-analyses) flow diagram). After screening the full text of the selected publications, one study (one publication) met the inclusion criteria. All studies were published in English."
Reasoning: The number of studies screened, assessed for eligibility, included and excluded were reported with reasons and a PRISMA flow diagram.
[Yes]

P18
Quote: "For a detailed description of studies, see Characteristics of included studies, Characteristics of excluded studies, and Characteristics of ongoing studies."
Reasoning: Characteristics of the one included study were presented.
[Yes]

P19
Quote: "Risk of bias summary: review authors' judgements about each risk of bias item for each included study (blank cells indicate that the study did not measure that particular outcome)."
Reasoning: A risk of bias summary figure showing review authors' judgements for each risk of bias domain was provided.
[Yes]

P20
Quote: "The one included study assessed 50 participants, and reported data for all primary and some secondary endpoints. All cause mortality, behaviour change, participants views of the intervention, socioeconomic effects and costs were not reported in this study."
Reasoning: Outcome data for the one included study were reported.
[Yes]

P21
Reasoning: Presentation of meta-analysis results was not applicable as no meta-analysis was performed.
[NA]

P22
Reasoning: Presentation of risk of bias across studies was not applicable as there was only one included study.
[NA]

P23
Reasoning: No additional analyses were reported.
[No]

P24
Quote: "This review reports the findings from one RCT (50 participants). The intervention focused on laparoscopic adjustable gastric banding surgery, which was compared to a control group receiving a multi component lifestyle program. The study authors were unable to blind their participants, personnel and outcome assessors which may have resulted in a high risk of performance and detection bias. At 24 months follow-up, the mean change in BMI units was 12.7 (95% CI 11.3 to 14.2) in the surgery group compared to 1.3 (95% CI 0.4 to 2.9) in the control group. Adverse events were reported in 12/25 participants in the intervention group compared to 11/25 in the control group."
Reasoning: The main findings and strength of evidence were summarized.
[Yes]

P25
Quote: "Our results are limited to two years of follow-up and are based on just one small Australian study with some risk of bias which was conducted in a private hospital, receiving funding from the gastric banding manufacturer. There is currently insufficient evidence to make an informed judgement about efficacy. Whilst an in-house economic evaluation was undertaken with due diligence, it is not viewed as a quick fix to weight loss but should be undertaken with due consideration required for the bespoke needs of an adolescent population."
Reasoning: Limitations at the study level (risk of bias, insufficient data) and review level (one small study) were discussed.
[Yes]

P26
Quote: "This systematic review highlights the lack of randomised controlled trials in this field. More high quality studies are required to assess the efficacy of bariatric surgery for the treatment of paediatric obesity and adolescents. The four ongoing studies, once completed, will provide additional evidence on bioenteric intragastric balloon and gastric bypass as alternative procedures in Australian and Swedish adolescents respectively, with two further European studies examining gastric banding. It is important for this research to address clinical effectiveness across a range of populations, including participants ranging in socio-demographics, ethnicity, baseline weight status and geography. Future studies should assess the impact of the surgical procedure and post operative care to minimise adverse events, including the need for post operative adjustments and revisional surgery. Long term follow-up is also critical to comprehensively assess the impact of surgery as participants enter adulthood."
Reasoning: The authors provided a general interpretation of the results in the context of the evidence base and implications for future research.
[Yes]

P27
Quote: "We would like to thank Leanne Mohan (Teesside University) and Gudrun Paletta (Cochrane Metabolic and Endocrine Disorders Group) for helping with review management."
Reasoning: Sources of funding for the systematic review were described, but not the role of the funders.
[No]

In summary, this systematic review met most of the AMSTAR quality criteria, except for not searching for grey literature, providing a list of excluded studies, mentioning the sources of funding for the included study, and assessing publication bias. For PRISMA reporting items, most were adequately addressed, with some exceptions like not presenting the full search strategies, a published protocol, and describing funding sources.

88. Elyas 2010: Is Staging Beneficial for Fowler-Stephens Orchiopexy? A Systematic Review

LLM response

27 quote(s) from publication full text (mean similarity 96.9%)

A1. Was an 'a priori' design provided?
Quote: "We conducted a systematic review to determine whether single or 2-stage Fowler-Stephens orchiopexy results in better testicular viability."
Reasoning: The research question was established before conducting the review.
[Yes]

A2. Was there duplicate study selection and data extraction?
Quote: "Each author was allocated roughly 10 articles, and independently abstracted the data and assessed the quality of the reports. Noncomparative case series were evaluated using a quality assessment instrument developed for this study."
Reasoning: Data extraction was done independently by each author.
[Yes]

A3. Was a comprehensive literature search performed?
Quotes: "We searched electronic databases, clinical trial registries and gray literature. We included reports describing boys younger than 18 years with a primary outcome of "testicular viability and position." We performed a meta-analysis using random effects models."
Reasoning: Multiple electronic databases and other sources were searched.
[Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
Quote: "We searched electronic databases, clinical trial registries and gray literature."
Reasoning: A search for gray literature was performed.
[Yes]

A5. Was a list of studies (included and excluded) provided?
Quote: "A total of 1,807 potentially relevant articles were retrieved from the initial electronic database search and an additional 13 studies from the gray literature search. After a thorough assessment 99 articles underwent a full review for evaluation of quality and 61 articles were included in the review (fig. 1)."
Reasoning: A flow diagram of included and excluded studies was provided.
[Yes]

A6. Were the characteristics of the included studies provided?
Quote: "The table summarizes the quality assessment results of the included articles."
Reasoning: A table summarizing key characteristics of included studies was provided.
[Yes]

A7. Was the scientific quality of the included studies assessed and documented?
Quote: "A calibration exercise was conducted to clarify any discordance. Each article was evaluated by 2 of us independently and any disagreement was resolved by consensus with the help of a third reviewer."
Reasoning: The quality of included studies was assessed using a quality assessment instrument.
[Yes]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
Quotes: "Although the rate of testicular survival is statistically significant in favor of the 2-stage procedure, a significant number were unclear about issues such as intraoperative testicular position, statistical analysis used and complications. Sample sizes were generally small, and no sample size calculations were reported."
Reasoning: Limitations in study quality were considered when drawing conclusions.
[Yes]

A9. Were the methods used to combine the findings of studies appropriate?
Quote: "We performed a meta-analysis using random effects models. Heterogeneity was assessed using I2 statistic."
Reasoning: Appropriate methods were used to combine study findings and assess heterogeneity.
[Yes]

A10. Was the likelihood of publication bias assessed?
Quote: "The funnel plot demonstrated a roughly symmetrical distribution around the mean effect, suggesting no publication bias."
Reasoning: A funnel plot was used to assess publication bias.
[Yes]

A11. Was the conflict of interest included?
Quotes: Not found
Reasoning: Sources of support for the systematic review and included studies were not clearly reported.
[No]

P1. Title
Quote: "Is Staging Beneficial for Fowler-Stephens Orchiopexy? A Systematic Review"
Reasoning: The title identifies the article as a systematic review.
[Yes]

P2. Abstract / Structured summary
Quote: The abstract contains labeled sections for Purpose, Materials and Methods, Results, and Conclusions.
Reasoning: A structured abstract with the required sections is provided.
[Yes]  

P3. Introduction / Rationale
Quote: "Fowler and Stephens showed that by dividing the spermatic vessels a high intra-abdominal testis could be brought into the scrotum. This particular approach carries a potential complication of this technique."
Reasoning: The rationale for the review is provided in the context of what is known.
[Yes]

P4. Introduction / Objectives
Quote: "We conducted a systematic review to determine whether single or 2-stage Fowler-Stephens orchiopexy results in better testicular viability."
Reasoning: An explicit statement of the review question is provided.
[Yes]

P5. Methods / Protocol and registration
Quotes: Not found
Reasoning: No mention of a review protocol or registration number.
[No]

P6. Methods / Eligibility criteria
Quote: "Studies were considered relevant if they met the following inclusion criteria. Patients were younger than 18 years, had an intra-abdominal testis, had undergone single or 2-stage FSO (open or laparoscopic), and had data regarding testicular position and postoperative testicular viability."
Reasoning: Study eligibility criteria are specified.
[Yes]

P7. Methods / Information sources
Quote: "We searched several electronic databases, including MEDLINE®, EMBASE®, CINAHL®, Cochrane Central Register of Control Trials, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects and ACP Journal Club®."
Reasoning: Electronic databases and other information sources are described.
[Yes]

P8. Methods / Search
Quotes: Not found
Reasoning: The full search strategy is not presented.
[No]

P9. Methods / Study selection
Quote: "The search strategy used in MEDLINE (Ovid interface) was Fowler Stephens.mp.; orchidopexy.mp.; orchiopexy.mp.; Laparoscopy [Abnormalities, Adverse Effects, Classification, Standards, Statistics and Numerical Data, Surgery, Methods, Trends, Utilization].; or/1-4.; Cryptorchid$.mp.; Undescended test$.mp.;"
Reasoning: The process for selecting studies is described.
[Yes]

P10. Methods / Data collection process
Quote: "Each author was allocated roughly 10 articles, and independently abstracted the data and assessed the quality of the reports."
Reasoning: The method of data extraction is described.
[Yes]

P11. Methods / Data items
Quotes: Not found
Reasoning: Variables for which data were sought are not explicitly defined.
[No]

P12. Methods / Risk of bias in individual studies
Quote: "Noncomparative case series were evaluated using a quality assessment instrument developed for this study. A calibration exercise was conducted to clarify any discordance. Each article was evaluated by 2 of us independently and any disagreement was resolved by consensus with the help of a third reviewer."
Reasoning: Methods for assessing risk of bias in individual studies are described.
[Yes]

P13. Methods / Summary measures
Quotes: Not found
Reasoning: The principal summary measures are not explicitly stated.
[No]

P14. Methods / Synthesis of results
Quote: "We performed a meta-analysis using random effects models."
Reasoning: The methods for combining study results are described.
[Yes]

P15. Methods / Risk of bias across studies
Quotes: Not found
Reasoning: Methods for assessing risk of bias across studies are not specified.
[No]

P16. Methods / Additional analyses
Quotes: Not found
Reasoning: No additional analyses are mentioned.
[NA]

P17. Results / Study selection
Quote: "A total of 1,807 potentially relevant articles were retrieved from the initial electronic database search and an additional 13 studies from the gray literature search. After a thorough assessment 99 articles underwent a full review for evaluation of quality and 61 articles were included in the review (fig. 1)."
Reasoning: The number of studies at each stage of selection is reported, with a flow diagram.
[Yes]

P18. Results / Study characteristics
Quote: "The table summarizes the quality assessment results of the included articles."
Reasoning: A table of study characteristics is provided.
[Yes]

P19. Results / Risk of bias within studies
Quotes: Not found
Reasoning: Results of the risk of bias assessment for each study are not presented.
[No]

P20. Results / Results of individual studies
Quote: "The forest plot demonstrates success rates of individual studies and pooled estimate success rate of 80% (95% CI 75 to 86) for single stage FSO with I2 of 11%."
Reasoning: A forest plot of individual study results is provided.
[Yes]

P21. Results / Synthesis of results
Quote: "The pooled estimate of success rates was 80% for single stage Fowler-Stephens orchiopexy (95% CI 75 to 86) and 85% for 2-stage Fowler-Stephens orchiopexy (95% CI 81 to 90). The pooled odds ratio of single stage vs 2-stage Fowler-Stephens orchiopexy was 2.0 (95% CI 1.1 to 3.9) favoring the 2-stage procedure."
Reasoning: Meta-analysis results with confidence intervals are reported.
[Yes]

P22. Results / Risk of bias across studies
Quotes: Not found
Reasoning: Results of the assessment of risk of bias across studies are not presented.
[No]

P23. Results / Additional analysis
Quotes: Not found
Reasoning: No additional analyses were mentioned in the methods.
[NA]

P24. Discussion / Summary of evidence
Quote: "Based on the results of this review, both approaches have a fairly high success rate, although 2-stage FSO appears to carry a higher rate of success over the single stage procedure, defined as postoperative viability of the testis (95% vs 80%, OR 2 in favor of 2-stage)."
Reasoning: The main findings are summarized.
[Yes]

P25. Discussion / Limitations
Quote: "Although laparoscopy allows for more precise dissection of the spermatic vessels, there was no statistical difference in success rates between open and laparoscopic FSO in either single or 2-stage techniques. The overall quality of the reports was average, and although most studies described the surgical technique and postoperative position of the testis, a significant number were unclear about issues such as intraoperative testicular position, statistical analysis used and complications."
Reasoning: Limitations at the study and review level are discussed.
[Yes]

P26. Discussion / Conclusions
Quote: "Based on the results of this review, both approaches have a fairly high success rate, although 2-stage FSO appears to carry a higher rate of success over the single stage procedure, defined as postoperative viability of the testis (95% vs 80%, OR 2 in favor of 2-stage). There was no difference in success rates between laparoscopic and open techniques."
Reasoning: The conclusions provide a general interpretation of the results.
[Yes]

P27. Funding
Quotes: Not found
Reasoning: Sources of funding for the systematic review are not described.
[No]

89. Esposito 2014: Laparoscopic Versus Open Inguinal Hernia Repair in Pediatric Patients: A Systematic Review

LLM response

15 quote(s) from publication full text (mean similarity 98.8%)

4 quote(s) from the LLM prompt briefing (mean similarity 49.8%) - were instructions quoted (ok) or examples (unwanted beahviour)?

A1
Quote: "A literature search was performed on all studies published during the last 20 years, reporting on outcomes of OH and LH, in terms of operative time, recurrence rate and other complications, finding of rare hernias, and incidence of contralateral patency."
Reasoning: The authors mention performing a literature search but do not explicitly state that the research question and inclusion criteria were established a priori.
Response: [No]

A2
Quotes: "Data extraction and analysis were independently performed by two authors." "Data regarding the following were considered: first author, publication date, study method, participant features, intervention characteristics, definition of complications, and outcome measures."
Reasoning: The authors state that data extraction was performed independently by two authors, but do not mention a consensus procedure for disagreements.
Response: [No]

A3
Quote: "A literature search was performed using PubMed, Cochrane, and Medline databases on all studies published during the last 20 years that described open or laparoscopic operation for inguinal hernia, and the latter was compared with conventional OH."
Reasoning: The authors searched 3 electronic databases (PubMed, Cochrane, Medline) which meets the minimum requirement of 2 databases, but do not provide the search terms, years, or full search strategy.
Response: [No]

A4
Reasoning: The authors do not state that they searched for reports regardless of publication type or whether they excluded any reports based on publication status or language.
Response: [No]

A5
Reasoning: The authors do not provide a list of included and excluded studies.
Response: [No]

A6
Quote: "Fifty-three studies matched the inclusion criteria and were selected for the final analysis."
Reasoning: While the authors report the number of included studies, they do not provide the characteristics of these studies in an aggregated form such as a table.
Response: [No]

A7
Quote: "The methodological quality of included studies was assessed independently by two authors."
Reasoning: The authors state they independently assessed the methodological quality of included studies.
Response: [Yes]

A8
Reasoning: The authors do not appear to have considered the scientific quality of included studies when formulating their conclusions and recommendations.
Response: [No]

A9
Reasoning: This systematic review does not include a meta-analysis or quantitative synthesis, so assessing the appropriateness of methods to combine study findings is not applicable.
Response: [NA]

A10
Reasoning: The authors do not mention assessing the likelihood of publication bias.
Response: [No]

A11
Reasoning: The authors do not report the sources of funding or support for the systematic review itself or for each included study.
Response: [No]

P1
Quote: "Laparoscopic Versus Open Inguinal Hernia Repair in Pediatric Patients: A Systematic Review"
Reasoning: The title identifies the article as a systematic review.
Response: [Yes]

P2
Quote: See the structured abstract on the first page with labeled sections for background, aim, materials and methods, results, and conclusions.
Reasoning: The article provides a structured abstract with the required sections.
Response: [Yes]

P3
Quote: "Inguinal hernia is one of the most common surgical conditions in infants and children. However, considerable debate exists regarding the role of laparoscopic hernia repair (herniorrhaphy) (LH) and its benefits over conventional open hernia repair (herniorrhaphy) (OH)."
Reasoning: The introduction describes the rationale for the review in the context of what is already known about the topic.
Response: [Yes]

P4
Quote: "The aim of this review is to analyze the current literature to determine the outcome of LH compared with OH."
Reasoning: The aim/objective of the review is explicitly stated, although it does not fully reference the PICOS elements.
Response: [No]

P5
Reasoning: The authors do not indicate if a review protocol exists or where it can be accessed.
Response: [No]

P6
Quote: "Eligibility criteria were all available English language for the full-text review and final analysis. Eligibility criteria included all available studies focused on LH and/or OH and with quantitative data on outcome parameters."
Reasoning: The eligibility criteria are reported, but the rationale is not provided.
Response: [No]

P7
Quote: "A literature search was performed using PubMed, Cochrane, and Medline databases on all studies published during the last 20 years that described open or laparoscopic operation for inguinal hernia, and the latter was compared with conventional OH."
Reasoning: The information sources (databases) are described but the dates of coverage and date last searched are not reported.
Response: [No]

P8
Reasoning: The authors do not present the full electronic search strategy for any of the databases.
Response: [No]

P9
Quote: "The full article was retrieved when the information in the title and/or abstract appeared to meet the objective of our review. The authors independently assessed selected studies and tabulated data from each article with a predefined data extraction form."
Reasoning: The study selection process is described in brief.
Response: [Yes]

P10
Quote: "Data extraction and analysis were independently performed by two authors."
Reasoning: The data extraction process is reported to have been done independently in duplicate.
Response: [Yes]

P11
Quote: "Data regarding the following were considered: first author, publication date, study method, participant features, intervention characteristics, definition of complications, and outcome measures."
Reasoning: The data items collected are listed.
Response: [Yes]

P12
Quote: "The methodological quality of included studies was assessed independently by two authors."
Reasoning: While the authors state that study quality was assessed, the specific methods used are not described.
Response: [No]

P13
Reasoning: The authors do not state the principal summary measures, as this review does not include a quantitative synthesis.
Response: [NA]

P14
Reasoning: This review does not include a meta-analysis, so describing methods for combining results and assessing consistency is not applicable.
Response: [NA]

P15
Reasoning: The authors do not specify any assessment of risk of bias across studies that may affect the cumulative evidence, such as publication bias or selective reporting.
Response: [No]

P16
Reasoning: The authors do not describe any additional analyses, as would be expected since this review does not include a meta-analysis.
Response: [NA]

P17
Quote: "Fifty-three studies matched the inclusion criteria and were selected for the final analysis."
Reasoning: The authors report the number of studies included but do not provide the full PRISMA flow diagram with the number of studies screened and excluded at each stage.
Response: [No]

P18
Quote: "Fifty-three studies matched the inclusion criteria and were selected for the final analysis."
Reasoning: While the number of included studies is reported, a table with the characteristics of each study is not provided.
Response: [No]

P19
Reasoning: The authors state that study quality was independently assessed but do not present the detailed results of the risk of bias assessment for each study.
Response: [No]

P20
Reasoning: The authors report some individual study results in the text and tables but do not systematically present effect estimates and confidence intervals for each study for all outcomes.
Response: [No]

P21
Reasoning: This review does not include a meta-analysis, so presenting the results of each meta-analysis is not applicable.
Response: [NA]

P22
Reasoning: The authors do not present any assessment of risk of bias across studies.
Response: [No]

P23
Reasoning: The authors do not report any additional analyses, as would be expected since this review does not include a meta-analysis.
Response: [NA]

P24
Quote: "In this systematic review, it seems that LH is faster than OH for bilateral hernias, whereas there is no significant difference in terms of operative time for unilateral inguinal hernia repair. Recurrence rate is similar for both techniques. As for other complications, such as wound infections, it is higher for OH compared with LH, especially in infants. A prospective comparative study is necessary on this topic to strongly support the results of our systematic review."
Reasoning: The authors summarize the main findings and their relevance in the discussion section.
Response: [Yes]

P25
Quote: "This review aims to evaluate the role of LH in children and to compare LH with OH in regard to operative time, postoperative complications, recurrence rate, discovering of rare hernias, and incidence of contralateral patency."
Reasoning: The authors discuss some limitations of the review in comparing LH to OH, but do not address limitations at the study level such as risk of bias.
Response: [No]

P26
Quote: "In conclusion, it seems that there is no evidence in literature about which technique (laparoscopy or inguinal approach) is preferable to repair an inguinal hernia. Probably a surgeon has to offer to the patient both techniques, and above all, considering the importance of the parental role in the decision process, the parents have to know that two different approaches exist to repair an inguinal hernia and the advantages and disadvantages of both procedures."
Reasoning: The authors provide a general interpretation of the results in the context of other evidence and implications for practice.
Response: [Yes]

P27
Reasoning: The authors do not describe sources of funding or other support for this systematic review.
Response: [No]

90. Feng 2016: Laparoscopic versus open splenectomy in children: a systematic review and meta-analysis

LLM response

16 quote(s) from publication full text (mean similarity 99.6%)

A1
Quote: "Literature searches were conducted to identify studies having compared the laparoscopic splenectomy (LS) and open splenectomy (OS) for children."
Reasoning: The research question and inclusion criteria were established before conducting the review.
[Yes]

A2
Quotes: "Included studies were independently reviewed by two reviewers, and a third reviewer was required for a final decision in the case of any discrepancies. The primary outcome measures of our analysis was to evaluate the operative time, blood loss, and length of postoperative stay."
Reasoning: Study selection and data extraction were done independently by at least two reviewers.
[Yes]

A3
Quote: "Published records were searched using the MEDLINE, EMBASE, and Web of Science from 1993 to 2015."
Reasoning: At least two electronic databases were searched.
[No] - No supplementary strategies like reviewing references, consulting experts, or searching specialized registers were mentioned.

A4
Reasoning: The authors did not state that they searched for reports regardless of publication type or whether any reports were excluded based on publication status or language.
[No]

A5
Reasoning: A list of included and excluded studies was not provided in the article.
[No]

A6
Quotes: See Tables 1, 2 and 3 which provide aggregate data on participant characteristics, interventions and outcomes.
Reasoning: Characteristics of the included studies were provided in aggregate form in tables.
[Yes]

A7
Quote: "For dichotomous data, we calculated odds ratios (ORs). Statistical heterogeneity in the meta-analysis was assessed with the χ2 test and the I2 index. A random-effects model was used in case of heterogeneous data. Otherwise, a fixed-effects model was used instead."
Reasoning: The scientific quality of included studies was assessed using statistical methods.
[Yes]

A8
Quote: "In conclusion, our study suggests that LS is a feasible, safe, and effective surgical procedure alternative to OS for pediatric patients. LS is associated with shorter hospital stays, less blood loss, and longer operative times compared with OS."
Reasoning: The results of the methodological rigor and scientific quality were considered in formulating the conclusions and recommendations.
[Yes]

A9
Quotes: "For dichotomous data, we calculated odds ratios (ORs). Statistical heterogeneity in the meta-analysis was assessed with the χ2 test and the I2 index. A random-effects model was used in case of heterogeneous data. Otherwise, a fixed-effects model was used instead."
Reasoning: Appropriate methods were used to combine findings, assessing heterogeneity and using a random-effects model for heterogeneous data.
[Yes]

A10
Reasoning: The likelihood of publication bias was not assessed.
[No]

A11
Reasoning: Potential sources of support or conflicts of interest were not acknowledged for the systematic review or the included studies.
[No]

P1
Quote: "Laparoscopic versus open splenectomy in children: a systematic review and meta-analysis"
Reasoning: The title identifies the article as a systematic review and meta-analysis.
[Yes]

P2
Reasoning: The article has an abstract but it is not structured with distinct labeled sections for background, objectives, data sources, etc.
[No]

P3
Quote: "Splenectomy is occasionally performed in children with various hematologic disorders such as sickle cell disease, idiopathic thrombocytopenic purpura, and so on [1]. Open splenectomy (OS) has some potential disadvantages such as abdominal wall scarring and the high risk of wound infection [2]."
Reasoning: The rationale for the review is described in the context of what is already known.
[Yes]

P4
Quote: "The primary outcome measures of our analysis was to evaluate the operative time, blood loss, and length of postoperative stay."
Reasoning: The questions being addressed specify the outcomes, but do not explicitly mention the participants, interventions, comparisons or study design.
[No]

P5
Reasoning: The article does not indicate if a review protocol exists or where it can be accessed.
[No]

P6
Reasoning: Study characteristics (participants, interventions, comparisons, outcomes) and report characteristics used as criteria for eligibility were not specified.
[No]

P7
Quote: "Published records were searched using the MEDLINE, EMBASE, and Web of Science from 1993 to 2015."
Reasoning: The information sources and dates of coverage are described but the date last searched is not provided.
[No]

P8
Reasoning: The full electronic search strategy is not presented such that it could be repeated.
[No]

P9
Quote: "Studies comparing LS and OS in children were included regardless of randomization or non-randomization. Inclusion criteria: (1) clinical trials that compared laparoscopic versus open splenectomy between 1993 and 2015; (2) children under 18 years old who suffered from benign or malignant hematological diseases; exclusion criteria: (1) no open splenectomy as a control; (2) reports fewer than ten cases per group; and (3) studies did not provide available original data or duplicate publications."
Reasoning: The process for selecting studies is stated.
[Yes]

P10
Quote: "Included studies were independently reviewed by two reviewers, and a third reviewer was required for a final decision in the case of any discrepancies."
Reasoning: The data extraction process is described but there is no mention of piloted forms or processes for obtaining and confirming data from investigators.
[No]

P11
Reasoning: The article does not list and define all variables for which data were sought.
[No]

P12
Reasoning: The article does not describe methods used for assessing risk of bias in individual studies.
[No]

P13
Quote: "For dichotomous data, we calculated odds ratios (ORs)."
Reasoning: Odds ratio is stated as the principal summary measure.
[Yes]

P14
Quote: "Statistical heterogeneity in the meta-analysis was assessed with the χ2 test and the I2 index. A random-effects model was used in case of heterogeneous data. Otherwise, a fixed-effects model was used instead."
Reasoning: The methods of handling data and combining results are described, including measures of consistency.
[Yes]

P15
Reasoning: The article does not specify any assessment of risk of bias that may affect the cumulative evidence.
[No]

P16
Reasoning: No additional analyses such as sensitivity analysis or meta-regression are described.
[No]

P17
Quote: See Figure 1 flow diagram.
Reasoning: A flow diagram is provided giving the numbers of studies screened, assessed for eligibility, and included with reasons for exclusions at each stage.
[Yes]

P18
Quotes: See Tables 1, 2 and 3.
Reasoning: For each included study, characteristics are presented including participant demographics, interventions, and outcome data along with citations.
[Yes]

P19
Reasoning: The article does not present data on risk of bias for each included study.
[No]

P20
Quotes: See forest plots in Figures 2-5.
Reasoning: For each outcome, simple summary data for each group and effect estimates with confidence intervals are presented in forest plots.
[Yes]

P21
Quotes: See forest plots in Figures 2-5.
Reasoning: The results of each meta-analysis are presented with confidence intervals and measures of consistency.
[Yes]

P22
[NA] - No assessment of risk of bias across studies was described.

P23
[NA] - No additional analyses were described.

P24
Quote: "In conclusion, our study suggests that LS is a feasible, safe, and effective surgical procedure alternative to OS for pediatric patients. LS is associated with shorter hospital stays, less blood loss, and longer operative times compared with OS."
Reasoning: The main findings are summarized including the strength of evidence for each main outcome.
[Yes]

P25
Quote: "On one hand, obvious heterogeneity was detected among different trials in terms of operative time, blood loss, and length of hospital stay."
Reasoning: Some limitations at the review level are discussed, but limitations at the study and outcome level are not.
[No]

P26
Quote: "In conclusion, our study suggests that LS is a feasible, safe, and effective surgical procedure alternative to OS for pediatric patients. LS is associated with shorter hospital stays, less blood loss, and longer operative times compared with OS. Furthermore, LS has a similar rate of the removal of accessory spleens and postoperative complications including postoperative high fever, ACS, and ileus when compared to OS in children."
Reasoning: A general interpretation of the results is provided in the context of other evidence and implications for future practice.
[Yes]

P27
Reasoning: Sources of funding for the systematic review are not described.
[No]

91. Feng 2015: Open Versus Laparoscopic Inguinal Herniotomy in Children

LLM response

29 quote(s) from publication full text (mean similarity 96.1%)

A1. Was an 'a priori' design provided?
Quotes: None relevant
Reasoning: The article does not mention a protocol, ethics approval, or pre-determined objectives.
[No]

A2. Was there duplicate study selection and data extraction?
Quotes: "The first author independently extracted data from the included studies. Details of publication (type of reporting the internal ring, trocars, and follow-up duration), inclusion and exclusion criteria, and demographics of the enrolled patients were collected and collated. Quality of the RCTs was assessed, including randomization, method of blinding, and allocation concealment."
Reasoning: Data extraction was done by one author, but no mention of duplicate study selection.
[No]

A3. Was a comprehensive literature search performed?
Quotes: "We systematically searched PubMed for relevant studies reported from 2005 to 2014 with the keywords "laparoscopic herniorrhaphy", "pediatric inguinal hernia," and "open herniorrhaphy." Total reference lists of selected articles were also included. We limited our searches to the publications written in English."
Reasoning: At least 2 electronic databases (PubMed and reference lists) were searched with keywords provided.
[Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
Quotes: None relevant
Reasoning: No mention of including grey literature or unpublished studies.
[No]

A5. Was a list of studies (included and excluded) provided?
Quotes: "Articles excluded because of failure to meet inclusion criteria (n = 235)"
Reasoning: A flow diagram shows the number of excluded studies, but no list is provided.
[No]

A6. Were the characteristics of the included studies provided?
Quotes: "Table 1. Study Details of Total Randomized Clinical Trials"
Reasoning: Key characteristics of the included studies are provided in an aggregated table.
[Yes]

A7. Was the scientific quality of the included studies assessed and documented?
Quotes: "Quality of the RCTs was assessed, including randomization, method of blinding, and allocation concealment."
"Table 2. Quality Check of Total Randomized Clinical Trials"
Reasoning: The quality of included studies was assessed using specified criteria and the results are provided in a table.
[Yes]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
Quotes: "Despite no significant difference was observed regarding the recurrence, LH can be accepted as the standard of care as long as total postoperative complications was substantially reduced, especially for major postoperative complications in male children."
Reasoning: The quality assessment results were considered when interpreting the findings and drawing conclusions.
[Yes]

A9. Were the methods used to combine the findings of studies appropriate?
Quotes: "Weighted mean differences and 95% confidence intervals (CI) were calculated for continuous variables and dichotomous variables, respectively. The confidence interval (CI) was established at 95%. Statistical heterogeneity in the meta-analysis was assessed with the χ2 test and the I2 index. If the I2 value was < 50%, then a fixed-effects meta-analysis was applied; if the I2 value was ≥ 50%, then a random-effects approach instead of a fixed-effect analysis would be undertaken."
Reasoning: Appropriate statistical methods were used to combine the study findings, assessing and accounting for heterogeneity.
[Yes]

A10. Was the likelihood of publication bias assessed?
Quotes: None relevant
Reasoning: The article does not mention assessing for publication bias.
[No]

A11. Was the conflict of interest included?
Quotes: "S.F. and L.Z. contributed equally to the manuscript. The authors declare no conflict of interest."
Reasoning: Conflicts of interest for the systematic review authors are reported, but not for the included studies.
[No]

P1. Title: Identify the report as a systematic review, meta-analysis, or both.
Quotes: "Open Versus Laparoscopic Inguinal Herniotomy in Children: A Systematic Review and Meta-Analysis Focusing on Postoperative Complications"
Reasoning: The title identifies the article as a systematic review and meta-analysis.
[Yes]

P2. Abstract / Structured summary
Quotes: The abstract contains labeled sections for Purpose, Methods, Results, Conclusions, and Key Words.
Reasoning: The abstract is structured with distinct sections covering the main elements.
[Yes]

P3. Introduction / Rationale
Quotes: "There is an ongoing debate about whether laparoscopic or open herniorrhaphy (LH or OH) is the best choice for inguinal hernia in children. The aim of this study was to compare both of the surgical strategies as regards operative time, recurrence rate, postoperative complications by means of a systematic review, and meta-analysis of the available literatures."
Reasoning: The introduction describes the rationale for conducting the review in the context of the ongoing debate.
[Yes]

P4. Introduction / Objectives
Quotes: "The aim of this study was to compare both of the surgical strategies as regards operative time, recurrence rate, postoperative complications by means of a systematic review, and meta-analysis of the available literatures."
Reasoning: The objectives are stated, mentioning the outcomes of interest and the synthesis methods.
[Yes]

P5. Methods / Protocol and registration
Quotes: None relevant
Reasoning: No mention of a review protocol or registration.
[No]

P6. Methods / Eligibility criteria
Quotes: "Total postoperative complications were significantly reduced in LH, especially for major postoperative complications in male children."
Reasoning: The eligibility criteria are briefly described, focusing on postoperative complications in male children.
[No]

P7. Methods / Information sources
Quotes: "We systematically searched PubMed for relevant studies reported from 2005 to 2014 with the keywords "laparoscopic herniorrhaphy", "pediatric inguinal hernia," and "open herniorrhaphy." Total reference lists of selected articles were also included. We limited our searches to the publications written in English."
Reasoning: PubMed and reference lists were searched up to 2014.
[Yes]

P8. Methods / Search
Quotes: "We systematically searched PubMed for relevant studies reported from 2005 to 2014 with the keywords "laparoscopic herniorrhaphy", "pediatric inguinal hernia," and "open herniorrhaphy.""
Reasoning: The search keywords are provided but the full search strategy for PubMed is not presented.
[No]

P9. Methods / Study selection
Quotes: "Our search was restricted to RCTs. Controlled clinical trials and comparative studies (including case-matched studies) were excluded. Eligibility criteria included total available studies comparing LH with OH for the repair of PIH. The children were younger than 18 years when they underwent LH or OH. The postoperative complications include postoperative vomiting, hydrocele, recurrence, iatrogenic ascent of the testis, testicular atrophy, scrotal edema, stitch granuloma, ugly scar and some of the complications are unique in male such as iatrogenic ascent of the testis and testicular atrophy. Two reviewers (S.F., Z.L.) screened the citation identified by the search strategy."
Reasoning: The study selection process is described, including eligibility criteria and involvement of two reviewers.
[Yes]

P10. Methods / Data collection process
Quotes: "The first author independently extracted data from the included studies. Details of publication (type of reporting the internal ring, trocars, and follow-up duration), inclusion and exclusion criteria, and demographics of the enrolled patients were collected and collated."
Reasoning: Data extraction was performed by one author using a data collection form.
[Yes]

P11. Methods / Data items
Quotes: "Details of publication (type of reporting the internal ring, trocars, and follow-up duration), inclusion and exclusion criteria, and demographics of the enrolled patients were collected and collated."
Reasoning: The data items collected are described.
[Yes]

P12. Methods / Risk of bias in individual studies
Quotes: "Quality of the RCTs was assessed, including randomization, method of blinding, and allocation concealment."
Reasoning: The methods for assessing risk of bias in the included RCTs are described.
[Yes]

P13. Methods / Summary measures
Quotes: "Weighted mean differences and 95% confidence intervals (CI) were calculated for continuous variables and dichotomous variables, respectively."
Reasoning: The summary measures (weighted mean differences, 95% CI) are specified.
[Yes]

P14. Methods / Synthesis of results
Quotes: "Statistical heterogeneity in the meta-analysis was assessed with the χ2 test and the I2 index. If the I2 value was < 50%, then a fixed-effects meta-analysis was applied; if the I2 value was ≥ 50%, then a random-effects approach instead of a fixed-effect analysis would be undertaken."
Reasoning: The methods for data synthesis are described, including assessing heterogeneity and using fixed or random effects models as appropriate.
[Yes]

P15. Methods / Risk of bias across studies
Quotes: None relevant
Reasoning: No methods for assessing risk of bias across studies (e.g. publication bias) are mentioned.
[No]

P16. Methods / Additional analyses
Quotes: None relevant
Reasoning: No additional analyses such as subgroup analyses or meta-regression are mentioned.
[No]

P17. Results / Study selection
Quotes: "The initial search strategy identified 249 citations and 14 of them were retrieved for full-text review. Five trials met the total inclusion criteria and had no exclusion criteria (Fig. 1): Chan et al,28 Koivusalo et al,29 Celebi et al,30 Shalaby et al,31 and Saranga et al.32 The 5 selected trials included 553 participants. Two hundred and seventy-eight patients received OH and 275 received LH. Study details are given in Table 1."
Reasoning: The number of studies screened, assessed for eligibility, and included are provided, with reasons for exclusions shown in a flow diagram.
[Yes]

P18. Results / Study characteristics
Quotes: "Table 1. Study Details of Total Randomized Clinical Trials"
Reasoning: The characteristics of the included studies are provided in a table with citations.
[Yes]

P19. Results / Risk of bias within studies
Quotes: "Table 2. Quality Check of Total Randomized Clinical Trials"
Reasoning: The results of the risk of bias assessment for each included study are presented in a table.
[Yes]

P20. Results / Results of individual studies
Quotes: The results for individual studies are provided in the forest plots in Figures 2-6.
Reasoning: Effect estimates and confidence intervals for each study are provided in the forest plots for all outcomes.
[Yes]

P21. Results / Synthesis of results
Quotes: The forest plots in Figures 2-6 show the pooled results.
Reasoning: The results of the meta-analyses with confidence intervals and measures of consistency are provided in the forest plots.
[Yes]

P22. Results / Risk of bias across studies
Quotes: None relevant
Reasoning: No results of assessment of risk of bias across studies (e.g. publication bias) are reported.
[No]

P23. Results / Additional analysis
Quotes: The forest plots in Figures 2-6 show results for subgroups.
Reasoning: The results of subgroup analyses are provided in the forest plots.
[Yes]

P24. Discussion / Summary of evidence
Quotes: "In this systematic review we summarized total RCTs available in the pediatric surgical literature, focusing on operative time, postoperative complications, and recurrence. Our results show that LH is superior for the inguinal hernia repair in children, with shorter operative time for unilateral hernias in extraperitoneal approaches group as well as for bilateral hernias. Besides, less total postoperative complications was found in the LH group, especially for major postoperative complications in male children."
Reasoning: The main findings are summarized, considering their relevance to pediatric surgical practice.
[Yes]

P25. Discussion / Limitations
Quotes: "Yet there are no significant difference regarding the recurrence rates between laparoscopic and open group. However, on one hand, because of the limited number of patients and studies, more RCTs need to be conducted to confirm these findings; on the other hand, the learning curve in the 5 RCTs may play an underestimated role in the study, which may weaken the results of the comparison."
Reasoning: Limitations of the small number of studies and patients as well as the learning curve are discussed.
[Yes]

P26. Discussion / Conclusions
Quotes: "In this systematic review we summarized total RCTs available in the pediatric surgical literature, focusing on operative time, postoperative complications, and recurrence. Our results show that LH is superior for the inguinal hernia repair in children, with shorter operative time for unilateral hernias in extraperitoneal approaches group as well as for bilateral hernias. Besides, less total postoperative complications was found in the LH group, especially for major postoperative complications in male children. Yet there is no significant difference regarding the recurrence. However, on one hand, because of the limited number of patients and studies, more RCTs need to be conducted to confirm these findings; on the other hand, the learning curve in the 5 RCTs may play an underestimated role in the study, which may weaken the results of the comparison."
Reasoning: The conclusions provide a general interpretation of the results and implications for future research.
[Yes]

P27. Funding
Quotes: "The authors declare no conflict of interest."
Reasoning: The authors declare no conflicts, but sources of funding for the systematic review are not described.
[No]

92. Friedmacher 2011: Residual aganglionosis after pull-through operation for Hirschsprung’s disease: a systematic review and meta-analysis

LLM response

14 quote(s) from publication full text (mean similarity 99.7%)

A1 - Was an 'a priori' design provided?
Quote: "A meta-analysis of redo PT operations for HD reported in the literature between 1985 and 2011 was performed. Detailed information was recorded in patients with RA and transition-zone bowel (TZB), including recurrent bowel problems, histological findings on repeat rectal biopsy, type of redo PT operation and outcome."
The authors specified the research question and inclusion criteria. [Yes]

A2 - Was there duplicate study selection and data extraction?
No relevant quotes found. The methods do not mention duplicate study selection and data extraction. [No]

A3 - Was a comprehensive literature search performed? 
Quote: "PubMed and MEDLINE databases were searched for all studies that reported cases of patients with HD who had undergone redo PT operations for RA or transition-zone bowel (TZB) after initial operation between 1985 and 2011."
At least 2 databases were searched with search terms and date ranges. [Yes]

A4 - Was the status of publication (i.e. grey literature) used as an inclusion criterion?
No relevant quotes found. The methods do not mention including grey literature or unpublished studies. [No]

A5 - Was a list of studies (included and excluded) provided?
The article contains a table (Table 1) listing the 24 included studies. However, no list of excluded studies is provided. [No]

A6 - Were the characteristics of the included studies provided?
Quote: "Twenty-nine articles reported 555 patients with HD who underwent redo PT operation. 193 (34.8%) patients demonstrated abnormal histological findings on repeat rectal biopsy, 144 (74.6%) patients revealed RA and 49 (25.4%) patients TZB (Table 1)."
The article provides aggregate characteristics of the included studies. [Yes]

A7 - Was the scientific quality of the included studies assessed and documented?
No relevant quotes found. The article does not mention assessing or reporting the quality of included studies. [No]

A8 - Was the scientific quality of the included studies used appropriately in formulating conclusions?
Not applicable, as the scientific quality of included studies was not assessed (A7). [NA]

A9 - Were the methods used to combine the findings of studies appropriate?
Not applicable, as this systematic review did not perform a meta-analysis. [NA]

A10 - Was the likelihood of publication bias assessed?
Not applicable, as this systematic review did not perform a meta-analysis. [NA]

A11 - Was the conflict of interest included?
No relevant quotes found. The article does not report sources of funding or conflicts of interest for the systematic review or included studies. [No]

P1 - Title
Quote: "Residual aganglionosis after pull-through operation for Hirschsprung's disease: a systematic review and meta-analysis"
The title identifies the article as a systematic review and meta-analysis. [Yes]

P2 - Abstract / Structured summary
The abstract contains labeled sections covering the background, methods, results, and conclusions. However, it is missing some elements like the full PICOS and registration number. [No]

P3 - Introduction / Rationale
Quote: "Over the years, various PT operations have been used to treat patients with HD [18–23]. It has been shown in several studies that there is no statistically significant difference in the functional outcome with respect to bowel function between the various PT procedures [24–27]."
The introduction describes the rationale for the review in the context of what is known. [Yes]

P4 - Introduction / Objectives
Quote: "We designed this meta-analysis to determine the incidence and outcome of residual aganglionosis (RA) in patients with HD following PT operation."
The introduction provides an explicit statement of the review question. [Yes]

P5 - Methods / Protocol and registration
No relevant quotes found. The article does not mention a protocol or registration. [No]

P6 - Methods / Eligibility criteria
Quote: "The search terms were "residual aganglionosis", "transition-zone bowel", "redo and repeat pull-through", "reoperation Hirschsprung's disease" and "postoperative follow-up and outcome Hirschsprung's disease"."
The methods section specifies the search terms used as eligibility criteria. However, it does not fully describe the PICOS and rationale. [No]

P7 - Methods / Information sources
Quote: "PubMed and MEDLINE databases were searched for all studies that reported cases of patients with HD who had undergone redo PT operations for RA or transition-zone bowel (TZB) after initial operation between 1985 and 2011."
The databases searched and dates of coverage are reported. [Yes]

P8 - Methods / Search
Quote: "The search terms were "residual aganglionosis", "transition-zone bowel", "redo and repeat pull-through", "reoperation Hirschsprung's disease" and "postoperative follow-up and outcome Hirschsprung's disease"."
The full search strategy is not provided, only the search terms used. [No]

P9 - Methods / Study selection
Quote: "Detailed information was recorded regarding type of study, gender, recurrent bowel symptoms, histological findings on repeat rectal biopsy, patient's age at initial PT and redo PT operation, type of surgical procedures performed and postoperative follow-up with recurrent symptoms."
The article describes the information extracted but not the full process for study screening and selection. [No]

P10 - Methods / Data collection process
No relevant quotes found. The data collection process is not described. [No]

P11 - Methods / Data items
Quote: "Detailed information was recorded regarding type of study, gender, recurrent bowel symptoms, histological findings on repeat rectal biopsy, patient's age at initial PT and redo PT operation, type of surgical procedures performed and postoperative follow-up with recurrent symptoms."
The article lists the data items collected. [Yes]

P12 - Methods / Risk of bias in individual studies
No relevant quotes found. Assessment of risk of bias in individual studies is not described. [No]

P13 - Methods / Summary measures
No relevant quotes found. The article does not state the principal summary measures. [No]

P14 - Methods / Synthesis of results
Not applicable, as this systematic review did not perform a meta-analysis. [NA]

P15 - Methods / Risk of bias across studies
Not applicable, as this systematic review did not perform a meta-analysis. [NA]

P16 - Methods / Additional analyses
Not applicable, as this systematic review did not perform a meta-analysis. [NA]

P17 - Results / Study selection
Quote: "Between 1985 and 2011, 29 published articles reported 555 patients with HD who underwent redo PT operation. 193 (34.8%) patients demonstrated abnormal histological findings on repeat rectal biopsy, 144 (74.6%) patients revealed RA and 49 (25.4%) patients TZB (Table 1)."
The number of included studies and patients is reported. However, the number of studies screened and excluded with reasons is not provided, ideally with a flow diagram. [No]

P18 - Results / Study characteristics
Quote: "24 articles (82.8%) were from single centers, and 5 (17.2%) were from multicenter studies."
The article reports some aggregate characteristics of included studies. However, characteristics of each individual study are not presented with citations. [No]

P19 - Results / Risk of bias within studies
No relevant quotes found. Results of risk of bias assessment for individual studies are not reported. [No]

P20 - Results / Results of individual studies
No relevant quotes found. Results are not presented for each individual study. [No]

P21 - Results / Synthesis of results
Not applicable, as this systematic review did not perform a meta-analysis. [NA]

P22 - Results / Risk of bias across studies
Not applicable, as this systematic review did not perform a meta-analysis. [NA]

P23 - Results / Additional analysis
Not applicable, as this systematic review did not perform a meta-analysis. [NA]

P24 - Discussion / Summary of evidence
Quote: "Our meta-analysis reveals that RA and TZB are the underlying causes of persistent bowel symptoms in one-third of all patients requiring redo PT operation."
The discussion summarizes the main findings. However, it does not address the strength of evidence for each main outcome. [No]

P25 - Discussion / Limitations
Quote: "One major problem with the intraoperative frozen section biopsies is that it can indicate the presence of ganglion cells without differentiating between hypo- and dysganglionosis [29]."
The discussion mentions some limitations but does not cover limitations at the study, outcome, and review levels. [No]

P26 - Discussion / Conclusions
Quote: "A redo PT operation for RA or TZB is potentially preventable by accurate identification of the proximal margin of the aganglionic bowel and transition-zone by an experienced histopathologist [28]."
The conclusion provides an interpretation of the results with implications for practice. [Yes]

P27 - Funding
No relevant quotes found. Sources of funding for the systematic review are not reported. [No]

93. Friedmacher 2012: Delayed primary anastomosis for management of long-gap esophageal atresia: a meta-analysis of complications and long-term outcome

LLM response

22 quote(s) from publication full text (mean similarity 99.2%)

A1
Quote: "A systematic literature search was conducted for relevant articles published between 1981 and 2011, and a meta-analysis of complications and long-term outcome was performed."
Reasoning: The authors mention conducting a systematic literature search for articles published between 1981 and 2011, indicating an a priori design.
[Yes]

A2
No relevant quotes found.
Reasoning: The authors do not mention duplicate study selection and data extraction.
[No]

A3
Quotes: "A systematic literature search was performed to identify articles reporting cases of LGEA managed by DPA. Common electronic databases as MEDLINE®, EMBASE®, ISI Web of ScienceSM and the Cochrane Library were searched in December 2011 using a combination of the following terms: "esophageal atresia", "long-gap" and "delayed primary anastomosis"."
Reasoning: The authors searched multiple electronic databases and provided the search terms used.
[Yes]

A4
No relevant quotes found.
Reasoning: The authors do not mention whether they included grey literature or unpublished studies.
[No]

A5
No relevant quotes found.
Reasoning: The authors do not provide a list of included and excluded studies.
[No]

A6
Quote: "The overall number of study subjects managed by DPA was 451, ranging from 1 to 74 newborns with LGEA per study. Study and patients characteristics are presented in Table 1."
Reasoning: The authors provide an aggregated table (Table 1) with characteristics of the included studies.
[Yes]

A7
Quote: "An unblinded, standardized full-text assessment of relevant articles was independently performed by both authors (F.F. and P.P.). The data was extracted into an electronic data-sheet in a standardized manner."
Reasoning: The authors independently assessed the full-text of relevant articles.
[Yes]

A8
No relevant quotes found.
Reasoning: The authors do not explicitly state that they considered methodological rigor or scientific quality in formulating conclusions and recommendations.
[No]

A9
Quote: "A cumulative meta-analysis revealed the incidences for each specific complication (Table 2). Since not all complications were reported in all articles, each specific complication was recorded as the number of patients in which that complication was present divided by the total number of patients in the cohorts that presented data on that specific complication."
Reasoning: The authors used appropriate methods to combine the findings, taking into account the number of patients for each complication.
[Yes]

A10
No relevant quotes found.
Reasoning: The authors do not mention assessing the likelihood of publication bias.
[No]

A11
No relevant quotes found.
Reasoning: The authors do not report the sources of funding or conflicts of interest for the included studies.
[No]

P1
Quote: "Delayed primary anastomosis for management of long-gap esophageal atresia: a meta-analysis of complications and long-term outcome"
Reasoning: The title identifies the article as a meta-analysis.
[Yes]

P2
Quote: See structured abstract on page 1.
Reasoning: The article provides a structured abstract with labeled sections for background, methods, results, and conclusion.
[Yes]

P3
Quote: "Esophageal atresia (EA) is a relatively common congenital malformation of unknown etiology with an incidence of 1 in 3,500 live births [1]. Pure EA without tracheoesophageal fistula (Fig. 1) is an uncommon variant, comprising 8 % of all patients with EA, with an expected incidence of 1 in 40,000 live births [2]."
Reasoning: The introduction describes the rationale for the review in the context of what is known about esophageal atresia.
[Yes]

P4
Quote: "Purpose Management of newborns with long-gap esophageal atresia (LGEA) remains a challenge for pediatric surgeons. Since spontaneous growth of the esophageal segments occurs without mechanical stretching, initial gastrostomy followed by delayed primary anastomosis (DPA) comprises treatment in most LGEA patients. This meta-analysis aimed to investigate the complications and long-term outcome in patients with LGEA managed by DPA."
Reasoning: The purpose statement provides an explicit statement of the question being addressed, referencing the population (newborns with LGEA), intervention (DPA), and outcomes of interest (complications and long-term outcome).
[Yes]

P5
No relevant quotes found.
Reasoning: The authors do not mention the existence of or access to a review protocol.
[No]

P6
Quote: "Identified articles were reviewed by title, keywords and abstract by one of the authors (F.F.). All articles that did not contain original research data (e.g. letters, editorials, commentaries and reviews) and articles not giving adequate information regarding complication rates and outcome were excluded. Articles in non-English languages were translated by qualified medical translators."
Reasoning: The authors specify the study characteristics used as criteria for eligibility.
[Yes]

P7
Quote: "A systematic literature search was performed to identify articles reporting cases of LGEA managed by DPA. Common electronic databases as MEDLINE®, EMBASE®, ISI Web of ScienceSM and the Cochrane Library were searched in December 2011 using a combination of the following terms: "esophageal atresia", "long-gap" and "delayed primary anastomosis". References lists of identified articles were screened for additional studies. There were no language or publication date restrictions. Duplicated articles were deleted."
Reasoning: The authors describe the databases searched, search terms used, and the date of the search.
[Yes]

P8
No relevant quotes found.
Reasoning: The authors do not present the full electronic search strategy such that it could be repeated.
[No]

P9
Quote: "An unblinded, standardized full-text assessment of relevant articles was independently performed by both authors (F.F. and P.P.). The data was extracted into an electronic data-sheet in a standardized manner."
Reasoning: The authors state the process for selecting studies, including full-text assessment by two authors independently.
[Yes]

P10
Quote: "Data extracted from each participating article included study characteristics (first author, publication year, sample size, follow-up time and mortality rate) and patient characteristics (gestational age, birth weight, type of LGEA and additional congenital anomalies). The primary outcome of this analysis was complication rates."
Reasoning: The authors describe the method of data extraction from each article.
[Yes]

P11
Quote: "Data extracted from each participating article included study characteristics (first author, publication year, sample size, follow-up time and mortality rate) and patient characteristics (gestational age, birth weight, type of LGEA and additional congenital anomalies)."
Reasoning: The authors list the variables for which data were sought from each study.
[Yes]

P12
Quote: "An unblinded, standardized full-text assessment of relevant articles was independently performed by both authors (F.F. and P.P.)."
Reasoning: The authors mention independently assessing the full-text of articles, but do not describe specific methods for assessing risk of bias.
[No]

P13
Quote: "Associations between complications were presented by relative risk (RR) and their 95 % CI. Statistical differences were considered as significant for a p value <0.05 (two-tailed)."
Reasoning: The authors state the principal summary measures as relative risk and 95% confidence intervals.
[Yes]

P14
Quote: "A cumulative meta-analysis revealed the incidences for each specific complication (Table 2). Since not all complications were reported in all articles, each specific complication was recorded as the number of patients in which that complication was present divided by the total number of patients in the cohorts that presented data on that specific complication. With these data, a cumulative meta-analysis was performed. This enabled the calculation of incidences with a 95 % confidence interval (CI) for each specific complication."
Reasoning: The authors describe the methods used for combining results in the meta-analysis, including calculating incidences and 95% confidence intervals for each complication.
[Yes]

P15
No relevant quotes found.
Reasoning: The authors do not mention assessing risk of bias across studies, such as publication bias or selective reporting.
[No]

P16
No relevant quotes found.
Reasoning: The authors do not describe any additional analyses.
[No]

P17
Quote: See Figure 2 flow diagram.
Reasoning: The authors provide a flow diagram showing the number of studies screened, assessed for eligibility, and included, with reasons for exclusions at each stage.
[Yes]

P18
Quote: See Table 1.
Reasoning: The authors provide a table (Table 1) presenting the characteristics of each included study.
[Yes]

P19
No relevant quotes found.
Reasoning: The authors do not present data on the risk of bias for each included study.
[No]

P20
Quote: See Table 2.
Reasoning: The authors present data for each complication in Table 2, including the number of studies, subjects, and incidence with 95% confidence interval.
[Yes]

P21
Quote: "A cumulative meta-analysis revealed the incidences for each specific complication (Table 2)."
Reasoning: The authors present the results of the meta-analysis in Table 2, including incidences and 95% confidence intervals for each complication.
[Yes]

P22
No relevant quotes found.
Reasoning: The authors do not report assessing risk of bias across studies.
[No]

P23
No relevant quotes found.
Reasoning: The authors do not report any additional analyses.
[No]

P24
Quote: "DPA provides good long-term functional results. However, the high incidence of GER and associated strictures requires early intervention to prevent feeding problems."
Reasoning: The authors summarize the main findings in the conclusion.
[Yes]

P25
Quote: "The disadvantage of waiting for the esophageal segments to grow and hypertrophy is prolonged hospital stay and constant threat of aspiration pneumonia, which requires continuous skilled nursing supervision [21]. It may also be argued that the initial prolonged hospitalization is expensive."
Reasoning: The authors discuss some limitations of the DPA approach.
[Yes]

P26
Quote: "In conclusion, this meta-analysis shows that the DPA provides good long-term functional results. However, the high incidence of GER and associated morbidities requires early intervention to prevent ongoing feeding problems due to strictures and esophagitis. Long-term follow-up is recommended because of the potential risk of Barrett's metaplasia."
Reasoning: The authors provide a general interpretation of the results and implications for long-term follow-up.
[Yes]

P27
Quote: "Conflict of interest The authors declare that they have no conflict of interests."
Reasoning: The authors declare they have no conflicts of interest, but do not describe sources of funding for the systematic review.
[No]

94. Frongia 2013: Comparison of LILT and STEP procedures in children with short bowel syndrome — A systematic review of the literature

LLM response

22 quote(s) from publication full text (mean similarity 99.7%)

A1. Was an 'a priori' design provided?
Quotes: None relevant.
Reasoning: No mention of a protocol, ethics approval, or pre-determined objectives.
[No]

A2. Was there duplicate study selection and data extraction?
Quotes: "Any disagreement during study selection and data extraction process was resolved by discussion between first author (GF) and senior authors (AM, SHC)."
Reasoning: Study selection and data extraction were done in duplicate with a consensus process.
[Yes]

A3. Was a comprehensive literature search performed?
Quotes: "A systematic literature search was carried out using the search terms "bowel lengthening", "intestinal lengthening", "longitudinal intestinal lengthening and tailoring", "LILT", "Bianchi procedure", "serial transverse enteroplasty" and "step procedure". The last search was done on December, 10th, 2012. The reference lists of retrieved relevant articles were also cross-screened for additional studies."
Reasoning: At least 2 sources (reference lists and unspecified databases) plus a supplementary strategy (cross-referencing) were used.
[Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
Quotes: None relevant.
Reasoning: No mention of including grey literature or unpublished studies.
[No]

A5. Was a list of studies (included and excluded) provided?
Quotes: "Fig. 2 Screening design and summarized number of screened reports with identified relevant and useable articles during the review process, using the modified flow chart according to the QUOROM statement by Moher et al. [10]."
Reasoning: A flow diagram of included and excluded studies at each stage was provided.
[Yes]

A6. Were the characteristics of the included studies provided?
Quotes: "Table 1 List of evaluated and reviewed STEP (n = 109) and LILT (n = 363) procedures in published case reports from 1991 to 2012."
Reasoning: Characteristics of included studies were provided in an aggregated table.
[Yes]

A7. Was the scientific quality of the included studies assessed and documented?
Quotes: None relevant.
Reasoning: No mention of assessing study quality or risk of bias.
[No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
[NA] - Quality assessment was not performed (A7).

A9. Were the methods used to combine the findings of studies appropriate?
Quotes: "The statistical analysis was performed using Microsoft Office Excel and SPSS 18.0 for Windows (SPSS Corp., Chicago, IL, USA). All available data were analyzed and the quantitative data have been presented in a descriptive manner as mean and range values, except for length of follow-up where median and range values were indicated."
Reasoning: Appropriate descriptive statistics were used to summarize the findings, but no meta-analysis was performed.
[NA]

A10. Was the likelihood of publication bias assessed?
[NA] - No meta-analysis was performed.

A11. Was the conflict of interest included?
Quotes: "Conflict of interest: None."
Reasoning: Conflicts of interest for the systematic review were reported, but not for the individual included studies.
[No]

P1. Title
Quotes: "Comparison of LILT and STEP procedures in children with short bowel syndrome — A systematic review of the literature"
Reasoning: The title identifies the article as a systematic review.
[Yes]

P2. Abstract / Structured summary
Quotes: The abstract is structured with labeled sections for Purpose, Methods, Results, and Conclusions.
Reasoning: A structured abstract with the required sections is provided.
[Yes]

P3. Introduction / Rationale
Quotes: "Short bowel syndrome (SBS) is a serious disorder in which the intestinal resorptive capacity is insufficient to provide an adequate alimentary supply [1]. The estimated incidence in children is 24.5 per 100,000 live births with a higher incidence reported in preterm infants [2]. The estimated mortality is 2/100,000 population/year for children with SBS under 4 years [2] and 37.5% of neonates with SBS [3]. SBS in children occurs after congenital or acquired loss of part of the intestine [4], in most cases due to gastroschisis, necrotizing enterocolitis, mid-gut volvulus and intestinal atresia [5]."
Reasoning: Relevant background information is provided to contextualize the rationale for the review.
[Yes]

P4. Introduction / Objectives
Quotes: "Purpose: To compare LILT and STEP, the two principal procedures to lengthen the native bowel in children with a short bowel syndrome (SBS), by discussing the indications and presenting the outcome from published data."
Reasoning: The objectives are clearly stated, referencing the population, interventions, and outcomes of interest.
[Yes]

P5. Methods / Protocol and registration
Quotes: None relevant.
Reasoning: No mention of a review protocol or registration.
[No]

P6. Methods / Eligibility criteria
Quotes: "Population: Studies of humans aged 0–18 years. Intervention: Bianchi and STEP procedure, either alone or in combination. Type of study: All study designs were eligible for inclusion. Case series with 1 or more cases were included."
Reasoning: Eligibility criteria for population, interventions, and study designs were provided.
[Yes]

P7. Methods / Information sources
Quotes: "A systematic literature search was carried out using the search terms "bowel lengthening", "intestinal lengthening", "longitudinal intestinal lengthening and tailoring", "LILT", "Bianchi procedure", "serial transverse enteroplasty" and "step procedure". The last search was done on December, 10th, 2012. The reference lists of retrieved relevant articles were also cross-screened for additional studies."
Reasoning: Databases were searched up to a specified date and reference lists were screened.
[Yes]

P8. Methods / Search
Quotes: None relevant.
Reasoning: The full search strategy is not provided for any of the databases.
[No]

P9. Methods / Study selection
Quotes: "One reviewer (GF) screened all titles and abstracts to assess whether each report was potentially eligible for inclusion and whether or not the full text was available. Then, the relevant full text articles of all studies, which were considered as appropriate ones, were reviewed by one researcher (GF) who evaluated the articles and extracted their data. Afterwards, two other reviewers checked the data extraction of studies to estimate reliability (SW and AN). Any disagreement during study selection and data extraction process was resolved by discussion between first author (GF) and senior authors (AM, SHC)."
Reasoning: The study selection process is described, involving screening of titles/abstracts, full-text review, and resolution of disagreements.
[Yes]

P10. Methods / Data collection process
Quotes: "One reviewer (GF) screened all titles and abstracts to assess whether each report was potentially eligible for inclusion and whether or not the full text was available. Then, the relevant full text articles of all studies, which were considered as appropriate ones, were reviewed by one researcher (GF) who evaluated the articles and extracted their data. Afterwards, two other reviewers checked the data extraction of studies to estimate reliability (SW and AN). Any disagreement during study selection and data extraction process was resolved by discussion between first author (GF) and senior authors (AM, SHC)."
Reasoning: The data extraction process is described, involving one researcher extracting data and two others checking for reliability.
[Yes]

P11. Methods / Data items
Quotes: None relevant.
Reasoning: The specific data items collected are not defined.
[No]

P12. Methods / Risk of bias in individual studies
Quotes: None relevant.
Reasoning: No risk of bias assessment was described.
[No]

P13. Methods / Summary measures
Quotes: "The statistical analysis was performed using Microsoft Office Excel and SPSS 18.0 for Windows (SPSS Corp., Chicago, IL, USA). All available data were analyzed and the quantitative data have been presented in a descriptive manner as mean and range values, except for length of follow-up where median and range values were indicated."
Reasoning: Summary measures (means, medians, ranges) are specified.
[Yes]

P14. Methods / Synthesis of results
[NA] - No meta-analysis was performed.

P15. Methods / Risk of bias across studies
[NA] - No meta-analysis was performed.

P16. Methods / Additional analyses
[NA] - No meta-analysis was performed.

P17. Results / Study selection
Quotes: "Fig. 2 Screening design and summarized number of screened reports with identified relevant and useable articles during the review process, using the modified flow chart according to the QUOROM statement by Moher et al. [10]."
Reasoning: A flow diagram of the study selection process with numbers at each stage is provided.
[Yes]

P18. Results / Study characteristics
Quotes: "Table 1 List of evaluated and reviewed STEP (n = 109) and LILT (n = 363) procedures in published case reports from 1991 to 2012."
Reasoning: Study characteristics are provided in an aggregated table with citations.
[Yes]

P19. Results / Risk of bias within studies
[NA] - No risk of bias assessment was performed (P12).

P20. Results / Results of individual studies
Quotes: None relevant.
Reasoning: Results for individual studies are not provided, only aggregated results.
[No]

P21. Results / Synthesis of results
[NA] - No meta-analysis was performed.

P22. Results / Risk of bias across studies
[NA] - No meta-analysis was performed.

P23. Results / Additional analysis
[NA] - No meta-analysis was performed.

P24. Discussion / Summary of evidence
Quotes: "The first pivotal aim in the therapy of SBS is to ensure alimentation of the child by parenteral nutrition (PN), which results in significant improvements in mortality rates and improved thrive and quality of life in paediatric SBS [65,66]. Nevertheless, the long-term application of parenteral nutrition is associated with multiple complications, primarily significant liver dysfunction. While first-line therapy is always conservative, surgery should be taken into account in cases of failed intestinal adaptation. LILT and STEP are both accepted procedures potentially able to wean the child from PN, therefore promoting intestinal autonomy and patient outcome."
Reasoning: The main findings are summarized with consideration of their relevance to key stakeholders.
[Yes]

P25. Discussion / Limitations
Quotes: "From literature data neither procedure seems to have an advantage over the other in this regard."
Reasoning: Some limitations are briefly mentioned, but not discussed in detail at the study and review levels.
[No]

P26. Discussion / Conclusions
Quotes: "Therefore, LILT and STEP are complementary and supportive to further therapeutic approaches. In comparison with SBTX, both procedures have less associated complications and are independent of the availability of donor organs [67]. The choice for one of both surgical options is essentially driven by feasibility of the procedures and the associated outcome. From the technical perspective STEP has many clear advantages over LILT (Table 4), as during STEP procedure the manipulation and dissection of the mesentery and vasculature are not necessary, which reduces the chance of vascular compromises in comparison with LILT [59]. STEP can be applied to reduce varying degrees of bowel dilatation and may be performed on short and asymmetrical segments of dilated bowel [36,60], which is not feasible with LILT. In intricate intestinal segments, such as the duodenum and adjacent jejunum, only STEP is feasible [34,38]."
Reasoning: The conclusions provide an interpretation of the results in the context of other evidence and implications for practice.
[Yes]

P27. Funding
Quotes: "Acknowledgments: The authors are very grateful to "Heidelberger Stiftung Chirurgie" for supporting this publication."
Reasoning: Sources of funding for the systematic review are described.
[Yes]

95. Gallo 2012: Long-Gap Esophageal Atresia: a Meta-Analysis of Jejunal Interposition, Colon Interposition, and Gastric Pull-Up

LLM response

19 quote(s) from publication full text (mean similarity 98.7%)

A1. Was an 'a priori' design provided?
Quotes: None relevant
Reasoning: The article does not mention a protocol, ethics approval, or pre-determined research objectives.
[No]

A2. Was there duplicate study selection and data extraction?
Quotes: "Data about postoperative mortality and morbidity were given in 14 studies with a total of 470 patients (264 LGEA): 344 (73%) patients underwent CI, 99 (21%) children underwent GPU, and 27 (6%) patients underwent JI."
Reasoning: The data extraction process is described, but there is no mention of it being done in duplicate.
[No]

A3. Was a comprehensive literature search performed?
Quotes: "A literature search (PubMed and Embase) was performed, and all human studies published in the English-language literature between 2006 and 2011 describing esophageal replacement for LGEA were identified, using the medical subject headings "Esophageal Atresia," "Long-gap," "Esophagoplasty," "Replacement," "Interposition," "Substitution," "Graft," and their combinations. All titles and abstracts were scanned and appropriate citations were reviewed. Also, a manual search of the bibliographies of relevant articles was done to identify publications for possible inclusion. Included were prospective, retrospective, and comparative studies."
Reasoning: At least 2 databases were searched and supplemented by scanning reference lists of included studies.
[Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
Quotes: None relevant
Reasoning: The inclusion criteria do not mention including grey literature or unpublished studies.
[No]

A5. Was a list of studies (included and excluded) provided?
Quotes: "A total of 15 studies (4 comparative retrospective, 8 retrospective, and 3 prospective) including 470 patients (264 LGEA) were identified; 344 (73%) patients underwent CI, 99 (21%) GPU, and 27 (6%) JI."
Reasoning: A list of included studies is provided in Table 1, but there is no list of excluded studies.
[No]

A6. Were the characteristics of the included studies provided?
Quotes: See Table 1 which provides author, year, replacement performed, number of patients, and study type for each included study.
Reasoning: Key characteristics of the included studies are provided in an aggregated table.
[Yes]

A7. Was the scientific quality of the included studies assessed and documented?
Quotes: None relevant
Reasoning: The article does not mention assessing or documenting the quality of included studies.
[No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
[NA] - Question A7 was answered "No"

A9. Were the methods used to combine the findings of studies appropriate?
Quotes: "Studies were divided into the following three groups: JI, CI, and GPU. To perform the statistical overview Comprehensive Meta Analysis software (Version 2.2.064) was used. Data were computed using a random effects approach."
Reasoning: Appropriate statistical methods were used to combine the findings of the studies.
[Yes]

A10. Was the likelihood of publication bias assessed?
[NA] - This systematic review did not include a meta-analysis.

A11. Was the conflict of interest included?
Quotes: "Conflict of interest: None"
Reasoning: A statement on conflict of interest is provided for the systematic review but not for each included study.
[No]

P1. Title
Quotes: "Long-Gap Esophageal Atresia: a Meta-Analysis of Jejunal Interposition, Colon Interposition, and Gastric Pull-Up"
Reasoning: The title identifies the article as a meta-analysis.
[Yes]

P2. Abstract / Structured summary
Quotes: See the structured abstract on the first page with labeled sections for Aim, Methods, Main Results, and Conclusion.
Reasoning: The article provides a structured abstract with the required sections.
[Yes]

P3. Introduction / Rationale
Quotes: "There is still no consensus about the optimal surgical approach for esophageal replacement in the case of long-gap esophageal atresia (LGEA) or extensive corrosive strictures. This is reflected in the pediatric surgical literature, which mainly consists of retrospective case series."
Reasoning: The introduction explains the rationale for the review in the context of lack of consensus on the optimal surgical approach.
[Yes]

P4. Introduction / Objectives
Quotes: "The aim of this article was to perform a meta-analysis comparing the most widely used techniques for esophageal replacement in children: jejunal interposition (JI), colon interposition (CI), and gastric pull-up (GPU)."
Reasoning: The objective of the review is clearly stated.
[Yes]

P5. Methods / Protocol and registration
Quotes: None relevant
Reasoning: The article does not mention a protocol or registration number.
[No]

P6. Methods / Eligibility criteria
Quotes: "The articles were reviewed with a special focus on mortality, postoperative morbidity, and long-term follow-up. Main outcome parameters were postoperative survival rate, anastomotic complications (such as leakage and strictures recorded both postoperative and during the follow-up), and graft loss. Secondary outcome parameters were early respiratory complications (pneumothorax, atelectasis, mediastinitis, pleural effusion, and temporary diaphragm/vocal cord paresis), hospital stay, and intensive care unit (ICU) stay."
Reasoning: The eligibility criteria in terms of outcome parameters are specified.
[Yes]

P7. Methods / Information sources
Quotes: "A literature search (PubMed and Embase) was performed, and all human studies published in the English-language literature between 2006 and 2011 describing esophageal replacement for LGEA were identified, using the medical subject headings "Esophageal Atresia," "Long-gap," "Esophagoplasty," "Replacement," "Interposition," "Substitution," "Graft," and their combinations."
Reasoning: The information sources (PubMed and Embase) and date range are provided.
[Yes]

P8. Methods / Search
Quotes: "A literature search (PubMed and Embase) was performed, and all human studies published in the English-language literature between 2006 and 2011 describing esophageal replacement for LGEA were identified, using the medical subject headings "Esophageal Atresia," "Long-gap," "Esophagoplasty," "Replacement," "Interposition," "Substitution," "Graft," and their combinations."
Reasoning: The search terms are provided but the full search strategy is not presented.
[No]

P9. Methods / Study selection
Quotes: "All titles and abstracts were scanned and appropriate citations were reviewed. Also, a manual search of the bibliographies of relevant articles was done to identify publications for possible inclusion. Included were prospective, retrospective, and comparative studies."
Reasoning: The process of scanning titles/abstracts and reviewing full-texts is described.
[Yes]

P10. Methods / Data collection process
Quotes: None relevant
Reasoning: The data collection process is not described in detail.
[No]

P11. Methods / Data items
Quotes: "The articles were reviewed with a special focus on mortality, postoperative morbidity, and long-term follow-up. Main outcome parameters were postoperative survival rate, anastomotic complications (such as leakage and strictures recorded both postoperative and during the follow-up), and graft loss. Secondary outcome parameters were early respiratory complications (pneumothorax, atelectasis, mediastinitis, pleural effusion, and temporary diaphragm/vocal cord paresis), hospital stay, and intensive care unit (ICU) stay. Long-term follow-up data focused on gastrointestinal and respiratory outcomes, when defined."
Reasoning: The data items collected are listed.
[Yes]

P12. Methods / Risk of bias in individual studies
Quotes: None relevant
Reasoning: The article does not mention assessing risk of bias in individual studies.
[No]

P13. Methods / Summary measures
Quotes: "Mortality is similar: postoperative survival rate after CI was 96%, after GPU 90.4%. Anastomotic strictures (16.3% after CI vs 17.7% after GPU) and graft loss (4.2% after CI vs 4.8% after GPU) are comparable after these two procedures."
Reasoning: The summary measures (survival rate, stricture rate, graft loss rate) are stated.
[Yes]

P14. Methods / Synthesis of results
[NA] - This systematic review did not include a meta-analysis.

P15. Methods / Risk of bias across studies
[NA] - This systematic review did not include a meta-analysis.

P16. Methods / Additional analyses
[NA] - This systematic review did not include a meta-analysis.

P17. Results / Study selection
Quotes: "A total of 15 studies (4 comparative retrospective, 8 retrospective, and 3 prospective) including 470 patients (264 LGEA) were identified; 344 (73%) patients underwent CI, 99 (21%) GPU, and 27 (6%) JI."
Reasoning: The number of included studies and patients is provided, but there is no flow diagram or details on studies excluded at each stage.
[No]

P18. Results / Study characteristics
Quotes: See Table 1 which provides author, year, replacement performed, number of patients, and study type for each included study.
Reasoning: The characteristics of each included study are presented.
[Yes]

P19. Results / Risk of bias within studies
Quotes: None relevant
Reasoning: The results do not include an assessment of risk of bias within studies.
[No]

P20. Results / Results of individual studies
Quotes: See Tables 2a, 2b, and 2c which provide outcome data for each individual study.
Reasoning: The results for each individual study are presented for the main outcomes.
[Yes]

P21. Results / Synthesis of results
[NA] - This systematic review did not include a meta-analysis.

P22. Results / Risk of bias across studies
[NA] - This systematic review did not include a meta-analysis.

P23. Results / Additional analysis
[NA] - This systematic review did not include a meta-analysis.

P24. Discussion / Summary of evidence
Quotes: "The present article set out to perform a meta-analysis of the literature regarding esophageal replacement for LGEA or extensive corrosive strictures. The aim of this article was to perform a meta-analysis comparing the most widely used techniques for esophageal replacement in children: jejunal interposition (JI), colon interposition (CI), and gastric pull-up (GPU). Methods Review of the English-language literature published in the past 5 years about esophageal replacement in children was done. The focus was on postoperative survival rate, morbidity (gastrointestinal complications such as anastomotic stenosis/leakage and respiratory complications such as pneumothorax, pneumonia, and atelectasis), and long-term follow-up when available. Among long-term gastrointestinal outcomes were dysphagia, reflux, and dumping; among long-term respiratory outcomes were recurrent pneumonia and recurrent aspiration leading to chronic lung disease."
Reasoning: The main findings are summarized, including the strength of evidence for key outcomes.
[Yes]

P25. Discussion / Limitations
Quotes: "Far fewer studies describe the results of GPU and only two authors have illustrated their experience with JI. If all studies about esophageal replacement for LGEA were similar we could compute a simple mean of the effect sizes, but considering the above mentioned methodological heterogeneity a simple comparison of the mean of the event rates described by different investigators seems inadequate. For this reason, we used a random effects model, using a weighted analysis of the most recent studies. Therefore the data depict an estimated overall effect. One should realize that this is only an approximation of reality and that conclusions should be carefully considered. However there are some tendencies that undeniably draw attention."
Reasoning: Limitations such as the small number of studies on GPU and JI and methodological heterogeneity are discussed.
[Yes]

P26. Discussion / Conclusions
Quotes: "Importantly, there is little mortality regardless of the type of replacement. In contrast, morbidity is significant. In 470 patients, 93 early respiratory complications and 262 early gastrointestinal complications are reported. Reoperations (e.g., because of graft loss or anastomotic leaks) were necessary in 6% of patients. Reoperation was most prevalent in one of the two JI studies, mainly because of dismal results in this small series (Cauchi et al's). However, the reoperation rate of 6% probably is an underestimation, as anastomotic strictures were mentioned in 74 patients (16% of cases) and one might expect that many of these were dilated, which should be considered a reoperation."
Reasoning: The conclusions provide a general interpretation of the results in the context of the evidence.
[Yes]

P27. Funding
Quotes: None relevant
Reasoning: The article does not provide information on funding sources.
[No]

96. Gosemann 2013: Open Versus Transanal Pull-Through for Hirschsprung Disease: A Systematic Review of Long-Term Outcome

LLM response

18 quote(s) from publication full text (mean similarity 99%)

1 quote(s) from the LLM prompt briefing (mean similarity 100%) - were instructions quoted (ok) or examples (unwanted beahviour)?

A1
Quote: "We performed a systematic literature review of the long-term outcome of OPEN surgery compared with L-TERPT/TERPT."
Reasoning: The research question and inclusion criteria were established before conducting the review.
[Yes]

A2
Quotes: "There should be at least two independent data extractors and a consensus procedure for disagreements should be in place. Note: 2 people do study selection, 2 people do data extraction, consensus process or one person checks the other's work."
Reasoning: The methods do not mention duplicate study selection and data extraction or a consensus procedure.
[No]

A3
Quotes: "A systematic PubMed search was performed to identify publications on outcome of children with HD, who underwent either OPEN, L-TERPT, or TERPT. This search was limited to the past 5 years (2008 to 2012) using the keywords "Hirschsprung" and "outcome." Reference lists were screened for additional studies."
Reasoning: At least two electronic databases were not searched, only PubMed was used along with reference screening.
[No]

A4
Reasoning: The inclusion of grey literature was not used as an inclusion criterion and there is no mention of including reports regardless of publication type.
[No]

A5
Quote: "Eighteen articles fulfilled the inclusion criteria and were analyzed in detail."
Reasoning: A list of included studies was not provided and excluded studies were not mentioned.
[No]

A6
Quotes: "A total of 387 patients were included in this review (range: 10 to 192 patients per study). Of these, 387 patients underwent open surgery for HD (OPEN), 481 children were operated on via L-TERPT, and 544 had a TERPT. The median number of patients in the OPEN group was n = 24 compared with n = 25 in the L-TERPT/TERPT group."
Reasoning: Aggregated data on the number of patients and surgical techniques were provided for the included studies.
[Yes]

A7
Quotes: "Only articles comprehensively describing the surgical methods (OPEN, L-TERPT, TERPT) and reporting on major outcome parameters (soiling/incontinence, constipation, enterocolitis, and/or stricture) were included in this study. Exclusion criteria were follow-up less than 12 months, cohorts smaller than 10 patients, articles in a language other than English, series of total colonic aganglionosis, and publication in nonpeer-reviewed journals."
Reasoning: The scientific quality of included studies was assessed based on described criteria for inclusion and exclusion.
[Yes]

A8
Reasoning: The results do not appear to account for the methodological rigor and scientific quality of the included studies when formulating conclusions and recommendations.
[No]

A9
Reasoning: This systematic review did not perform a meta-analysis or any pooling of study results.
[NA]

A10
Reasoning: The likelihood of publication bias was not assessed.
[No]

A11
Reasoning: The sources of funding and conflicts of interest for the systematic review and included studies were not reported.
[No]

P1
Quote: "Open Versus Transanal Pull-Through for Hirschsprung Disease: A Systematic Review of Long-Term Outcome"
Reasoning: The title identifies the article as a systematic review.
[Yes]

P2
Quote: "Abstract Introduction Various surgical techniques for the treatment of Hirschsprung disease (HD) have been proposed. The most relevant long-term complications of HD surgery include constipation, soiling/incontinence, enterocolitis, and anastomotic stricture. To date, there has been no randomized controlled trial evaluating the long-term outcome of OPEN surgery compared with transanal approaches with and without laparoscopy (laparoscopic-assisted transanal-endorectal pull-through [L-TERPT] and transanal-endorectal pull-through [TERPT]). We performed a systematic literature review of the long-term outcome of OPEN surgery compared with L-TERPT/TERPT."
Reasoning: The article provides a structured abstract summarizing the background, methods, and results.
[Yes]

P3
Quote: "Various surgical procedures for the treatment of Hirschsprung disease (HD) have been proposed. The principle of all techniques is the resection of the aganglionic segment and anastomosis."
Reasoning: The introduction describes the rationale for the review in the context of existing surgical treatments for Hirschsprung disease.
[Yes]

P4
Quote: "We performed a systematic literature review of the long-term outcome of OPEN surgery compared with L-TERPT/TERPT."
Reasoning: The introduction provides an explicit statement of the question being addressed (comparing long-term outcomes of open vs transanal pull-through surgery).
[Yes]

P5
Reasoning: The existence of a review protocol and registration information are not reported.
[No]

P6
Quotes: "Only articles comprehensively describing the surgical methods (OPEN, L-TERPT, TERPT) and reporting on major outcome parameters (soiling/incontinence, constipation, enterocolitis, and/or stricture) were included in this study. Exclusion criteria were follow-up less than 12 months, cohorts smaller than 10 patients, articles in a language other than English, series of total colonic aganglionosis, and publication in nonpeer-reviewed journals."
Reasoning: The inclusion and exclusion criteria related to study characteristics and report characteristics are specified.
[Yes]

P7
Quote: "A systematic PubMed search was performed to identify publications on outcome of children with HD, who underwent either OPEN, L-TERPT, or TERPT. This search was limited to the past 5 years (2008 to 2012) using the keywords "Hirschsprung" and "outcome." Reference lists were screened for additional studies."
Reasoning: The information sources searched are described (PubMed and reference lists) but the date last searched is not provided.
[No]

P8
Reasoning: The full search strategy is not presented for any of the databases searched.
[No]

P9
Quote: "Eighteen articles fulfilled the inclusion criteria and were analyzed in detail."
Reasoning: The number of included studies is provided but the process of screening and selecting studies is not described in detail.
[No]

P10
Reasoning: The data collection process is not described, such as whether data extraction forms were used, if it was done in duplicate, and if data was obtained or confirmed with study investigators.
[No]

P11
Reasoning: The data items sought for extraction are not defined, such as PICOS elements, funding sources, or any assumptions made.
[No]

P12
Reasoning: The methods do not describe assessing risk of bias in the individual included studies.
[No]

P13
Reasoning: The principal summary measures are not explicitly stated, such as risk ratios or mean differences.
[No]

P14
Reasoning: A meta-analysis was not performed in this systematic review.
[NA]

P15
Reasoning: Methods for assessing risk of bias that may affect the cumulative evidence, such as publication bias or selective reporting, are not specified.
[No]

P16
Reasoning: Additional analyses such as sensitivity analysis, subgroup analysis, or meta-regression were not mentioned.
[NA]

P17
Quote: "Eighteen articles fulfilled the inclusion criteria and were analyzed in detail."
Reasoning: The number of included studies is provided but a flow diagram is not included showing the numbers screened and excluded at each stage with reasons.
[No]

P18
Quotes: "A total of 387 patients were included in this review (range: 10 to 192 patients per study). Of these, 387 patients underwent open surgery for HD (OPEN), 481 children were operated on via L-TERPT, and 544 had a TERPT. The median number of patients in the OPEN group was n = 24 compared with n = 25 in the L-TERPT/TERPT group. Median age at surgery was 13 months in the OPEN group (range 3 to 42 months) compared with 7 months in the L-TERPT/TERPT group (range 2 to 30 months)."
Reasoning: Study characteristics including number of patients, surgical techniques, and age at surgery are presented for each included study.
[Yes]

P19
Reasoning: The results do not present data on the risk of bias for each included study.
[No]

P20
Reasoning: Simple summary data and effect estimates for each study are not provided for the outcomes considered.
[No]

P21
Reasoning: A meta-analysis was not performed.
[NA]

P22
Reasoning: An assessment of risk of bias across studies was not reported.
[No]

P23
Reasoning: Additional analyses were not performed.
[NA]

P24
Quote: "Functional outcome of surgical techniques for HD is highly variable. The results of the current study confirm a significant advantage of L-TERPT/TERPT over OPEN surgery in terms of soiling/incontinence and constipation. In contrast, no differences were seen for enterocolitis and anastomotic stricture."
Reasoning: The discussion summarizes the main findings including the strength of evidence for the main outcomes.
[Yes]

P25
Quote: "Although the present review of the recent literature revealed a higher incidence of constipation and soiling/incontinence after OPEN surgery compared with L-TERPT/TERPT, these data need to be carefully interpreted. The following limitations of the present analysis and validity of the data on the long-term outcome in the current literature may be discussed:"
Reasoning: Limitations of the review are discussed, such as the need to carefully interpret the data due to limitations of the current literature.
[Yes] 

P26
Quote: "Prospective, randomized, multicenter trials are urgently needed to overcome this weakness of the current literature."
Reasoning: The conclusions provide implications for future research, stating the need for prospective randomized multicenter trials.
[Yes]

P27
Reasoning: Sources of funding for the systematic review and the role of funders are not described.
[No]

97. Graziano 2015: Asymptomatic malrotation: Diagnosis and surgical management

LLM response

14 quote(s) from publication full text (mean similarity 99.1%)

2 quote(s) from the LLM prompt briefing (mean similarity 100%) - were instructions quoted (ok) or examples (unwanted beahviour)?

A1. Was an 'a priori' design provided?
"Ryerson et al. from Los Angeles retrospectively evaluated 224 patients with severe CHD over an eight year period [8]."
The review was conducted retrospectively, suggesting no a priori design was provided.
[No]

A2. Was there duplicate study selection and data extraction?
No relevant quotes found. The authors do not mention any duplicate study selection or data extraction processes.
[No]

A3. Was a comprehensive literature search performed?
"Adhering to PRISMA guidelines, a broad-based search strategy was conducted with two separate authors and librarians involved. MeSH headings and terms used are listed along with the number of citations retrieved with each search (Table 1). Included were all English language prospective studies and meta-analyses, retrospective cohort studies, large case series and comparison case series."
A broad search was conducted using MeSH terms and multiple databases. Supplementary strategies like consulting librarians were also used.
[Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
No relevant quotes found. The inclusion of grey literature is not mentioned.
[No]

A5. Was a list of studies (included and excluded) provided?
No relevant quotes found. Neither included nor excluded study lists are provided in the text.
[No]

A6. Were the characteristics of the included studies provided?
"For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations."
The review provides study characteristics and citations for the included studies.
[Yes]

A7. Was the scientific quality of the included studies assessed and documented?
"The evidence was graded and the recommendations classified based on the Oxford system."
The methodological quality of included studies was assessed using the Oxford system.
[Yes]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
"The evidence was graded and the recommendations classified based on the Oxford system."
The graded evidence based on study quality was used to classify the recommendations.
[Yes]

A9. Were the methods used to combine the findings of studies appropriate?
No relevant quotes found. This appears to be a systematic review without a meta-analysis, so quantitative synthesis methods are not applicable.
[NA]

A10. Was the likelihood of publication bias assessed?
No relevant quotes found. Publication bias is not mentioned in the text.
[NA] 

A11. Was the conflict of interest included?
No relevant quotes found. Conflicts of interest are not reported for the systematic review or the included studies.
[No]

P1. Title
"Asymptomatic malrotation: Diagnosis and surgical management An American Pediatric Surgical Association outcomes and evidence based practice committee systematic review"
The title identifies the article as a systematic review.
[Yes]

P2. Abstract / Structured summary
The abstract is structured with labeled sections including Background, Methods, Results, and Conclusions.
[Yes]

P3. Introduction / Rationale
"Malrotation, also known as intestinal rotation abnormality (IRA), can pose a great risk to the pediatric patient owing to the potential for a catastrophic event such as midgut volvulus, ischemic bowel, and possible short bowel syndrome or death [1]. In the past few decades, imaging modalities for this disorder have improved and become more commonplace. This has resulted in asymptomatic patients being diagnosed with malrotation incidentally during their workups for congenital heart disease or other anomalies [2]."
The introduction provides rationale for the review in the context of what is known about malrotation and its diagnosis.
[Yes]

P4. Introduction / Objectives
"The treatment of asymptomatic malrotation is controversial. Methods: Data were compiled from a broad search of Medline, Cochrane, Embase and Web of Science from January 1980 through January 2013 for five questions regarding asymptomatic malrotation."
The objectives are stated in terms of the questions the review aims to address.
[Yes]

P5. Methods / Protocol and registration
No relevant quotes found. A protocol or registration number is not mentioned.
[No]

P6. Methods / Eligibility criteria
"Included were all English language prospective studies and meta-analyses, retrospective cohort studies, large case series and comparison case series. Databases searched included MEDLINE (1980–April 2014), PubMed (1980–May 2014), and the Cochrane collection. We further divided the searches into those published from 1980 through the end of 1999 and those published after the year 2000."
Eligibility criteria for study designs, language, and publication dates are provided with rationale.
[Yes]

P7. Methods / Information sources
"Databases searched included MEDLINE (1980–April 2014), PubMed (1980–May 2014), and the Cochrane collection."
The databases searched and dates of coverage are described.
[Yes]

P8. Methods / Search
Table 1 provides the MeSH search terms used, though the full electronic search strategy is not presented in a way that it could be repeated.
[No]

P9. Methods / Study selection
"A total of 224 abstracts were found in a broad search strategy and screened. No prospective studies were found. Therefore, evaluation of the available literature regarding screening for malrotation included retrospective single institution case series that had no comparison groups. Historic data, selection bias, and institutional bias were noted in most studies."
The study selection process is described, from screening of abstracts to inclusion of retrospective case series.
[Yes]

P10. Methods / Data collection process
No relevant quotes found. The data collection process is not described.
[No]

P11. Methods / Data items
No relevant quotes found. Variables for which data were sought are not defined.
[No]

P12. Methods / Risk of bias in individual studies
No relevant quotes found. Assessment of risk of bias in individual studies is not mentioned.
[No]

P13. Methods / Summary measures
No relevant quotes found. Principal summary measures are not stated.
[No]

P14. Methods / Synthesis of results
Not applicable for a systematic review without meta-analysis.
[NA]

P15. Methods / Risk of bias across studies
Not applicable for a systematic review without meta-analysis.
[NA]

P16. Methods / Additional analyses
Not applicable for a systematic review without meta-analysis.
[NA]

P17. Results / Study selection
"A total of 224 abstracts were found in a broad search strategy and screened. No prospective studies were found. Therefore, evaluation of the available literature regarding screening for malrotation included retrospective single institution case series that had no comparison groups."
The number of studies screened and included is provided, though a full flow diagram is not included.
[Yes]

P18. Results / Study characteristics
Study characteristics like number of patients, age, and postop bowel obstruction are provided for each included study in Table 4.
[Yes]

P19. Results / Risk of bias within studies
No relevant quotes found. Assessment of risk of bias in individual studies is not provided.
[No]

P20. Results / Results of individual studies
"For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot."
Simple summary data is provided for each study in Table 4, but effect estimates and confidence intervals are not reported.
[No]

P21. Results / Synthesis of results
Not applicable for a systematic review without meta-analysis.
[NA]

P22. Results / Risk of bias across studies
Not applicable for a systematic review without meta-analysis.
[NA]

P23. Results / Additional analysis
Not applicable for a systematic review without meta-analysis.
[NA]

P24. Discussion / Summary of evidence
"The present review revealed a paucity of prospective studies evaluating patients with malrotation, and in particular, patients with congenital heart disease and intestinal rotation abnormalities."
The main findings are summarized, considering their relevance to the population of interest.
[Yes]

P25. Discussion / Limitations
"Historic data, selection bias, and institutional bias were noted in most studies."
Limitations at the study level are discussed.
[Yes]

P26. Discussion / Conclusions
"We recommend that each major institution evaluates their current approach to patients with asymptomatic malrotation and creates a consistent plan of management that can be studied and revised as needed. Our review would support the following management algorithm: When a patient is diagnosed with malrotation as a result of a screening study, particularly on another study considering should be given to three factors: 1) presence of symptoms, 2) status of cardiac disease, and 3) age. All patients need to undergo an UGI to confirm the diagnosis. At that point an attempt should be made to further define the anatomy as to whether the patient has true malrotation with a narrow mesenteric stalk, nonrotation with a broad mesentery or patient anatomy with malposition of the duodenum. Patients who are symptomatic should undergo a diagnostic laparoscopy and Ladd procedure but in "normal" anatomy is confirmed. True malrotation may be considered abnormal. Nonrotation and atypical anatomy with duodenal malposition may be more difficult to reliably diagnose since there are some false positives and false negative with any radiologic studies."
A general interpretation of the results is provided in the context of other evidence, with implications for future practice.
[Yes]

P27. Funding
No relevant quotes found. Sources of funding are not described.
[No]

98. Guo 2011: Laparoscopic versus open orchiopexy for non-palpable undescended testes in children: a systemic review and meta-analysis